Presentation Authors: Ahmed A. Hussein*, Ahmed S. Elsayed, Naif A. Aldhaam, Buffalo, NY, Ashok Hemal, winston salem, NC, Juan Palou, Catalonia, Spain, Michael Stöckle, hamburg, Germany, Jihad Kaouk, Cleveland, OH, Paul May, Buffalo, NY, Hannah Kiss, Aalst, Belgium, Zhe Jing, Osei Jennifer A, buffalo, NY, James O. Peabody, Detroit, MI, Alexandre Mottrie, Aalst, Belgium, Mani Menon, Detroit, MI, Khurshid A. Guru, Buffalo, NY
Introduction: Radical cystectomy is the gold standard for muscle invasive bladder cancer. Robot-assisted surgery has been accepted as a suitable alternative. Critics of robot-assisted radical cystectomy (RARC) have shown consensus regarding long term oncologic outcomes. Multi-institutional, ten-year oncologic outcomes for RARC have not been previously reported.
Methods: A retrospective review of the prospectively maintained International Robotic Cystectomy Consortium database was performed. At present 7 institutions of 26 in patients who had RARC over 10 years. 240 patients were reviewed for demographics and perioperative outcomes. Kaplan Meier curves were used to model disease specific survival (DSS), recurrence free survival (RFS), and overall survival (OS) (Fig1a, f). Multivariate Cox regressions models were used to identify predictors.
Results: Mean age was 67Â±11 (range 28-90), BMI was 28 Â±5, and the mean follow up was 47Â±45 months. 40% patients had a high ASA score (â‰¥3). 6% patients received neoadjuvant chemotherapy. Intracorporeal diversion was adopted in 9% patients and 15% received neobladders. Median operative time was 6.5 hrs with estimated blood loss of 400 ml. Overall complications occurred in 65% and high grade complications were observed in 23%. Distant recurrences were noticed in 27% and local recurrences in 16%. The 10-year DSS (Fig 1a), and RFS (Fig 1b) for â‰¤ pT2 vs â‰¥pT3 rates were 83% vs 45% , and 79% vs 40% respectively. The 10-year DSS (Fig 1d), and RFS (Fig 1e), for lymph node negative vs positive rates were 75% vs 25% , and 68% vs 26%, respectively. Ten years OS was 37%. Multivariate regression identified node positive disease as a negative predictors for DSS (p < 0.01), RFS (p < 0.01), and OS (p < 0.01). Also final pathology of â‰¥T3 was negative predictor of DSS (p < 0.01), RFS (p < 0.01), and OS (p < 0.01).
Conclusions: Long-term oncologic outcomes of RARC are acceptable in the IRCC cohort.
Source of Funding: Roswell Park Alliance Foundation and Vattikuti Foundation