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Survival after radical cystectomy for bladder cancer:Multicenter comparison between minimally invasive and open approaches

查看全文 作　　者：Weibin [1,2]Xie;Junming [1,2]Bi;Qiang [3]Wei;Ping [3]Han;Dongkui [4]Song;Lei [4]Shi;Dingwei [5,6]Ye;Yijun [5,6]Shen;Xin [7]Gou;Weiyang [7]He;Shaogang [8]Wang;Zheng [8]Liu;Jinhai [9]Fan;Kaijie [9]Wu;Zhiwen [10]Chen;Xiaozhou [10]Zhou;Chuize [11]Kong;Yang [11]Liu;Chunxiao [12]Liu;Abai [12]Xu;Baiye [13]Jin;Guanghou [13]Fu;Wei [14]Xue;Haige [14]Chen;Tiejun [15]Pan;Zhong [15]Tu;Tianxin [1,2]Lin;Jian [1,2]Huang 高影响力作者 机构地区：[1]Department of Urology,Sun Yat-sen Memorial Hospital,Sun Yat-sen University,Guangzhou,China;[2]Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation,Sun Yat-Sen Memorial Hospital,Sun Yat-Sen University,Guangzhou,China;[3]Department of Urology,West China Hospital,Sichuan University,Chengdu,China;[4]Department of Urology,The First Affiliated Hospital of Zhengzhou University,Zhengzhou,China;[5]Department of Urology,Fudan University Shanghai Cancer Center,Shanghai,China;[6]Department of Oncology,Shanghai Medical College,Fudan University,Shanghai,China;[7]Department of Urology,The First Affiliated Hospital of Chongqing Medical University,Chongqing,China;[8]Department of Urology,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan,China;[9]Department of Urology,The First Affiliated Hospital of Xi’an Jiaotong University,Xi’an,China;[10]Department of Urology,First Affiliated Hospital of Army Medical University,Urology Institute of People Liberation Army,Chongqing,China;[11]Department of Urology,The First Hospital of China Medical University,Shenyang,China;[12]Department of Urology,Zhujiang Hospital of Southern Medical University,Guangzhou,China;[13]Department of Urology,The First Affiliated Hospital,School of Medicine,Zhejiang University,Hangzhou,China;[14]Department of Urology,Renji Hospital,Shanghai Jiaotong University School of Medicine,Shanghai,China;[15]Department of Urology,General Hospital of Central Theater Command of the People’s Liberation Army,Wuhan,China高影响力机构 出　　处：《Asian Journal of Urology》索引2020年第7卷第3期,共10页高影响力期刊 基　　金：supported by the National Natural Science Foundation of China(Grant No.81825016,81772719,81772728,81572514);the Key Areas Research and Development Program of Guangdong(Grant No.2018B010109006);Medical Scientific Research Foundation of Guangdong Province(Grant No.A2018388). 摘　　要：Objective:To investigate oncological outcomes in patients with bladder cancer who underwent minimally invasive radical cystectomy(MIRC)or open radical cystectomy(ORC).Methods:We identified patients with bladder cancer who underwent radical cystectomy(RC)in 13 centers of the Chinese Bladder Cancer Consortium(CBCC).Perioperative outcomes were compared between MIRC and ORC.The influence of surgical approaches on overall survival(OS)and cancer-specific survival(CSS)in the entire study group and subgroups classified according to pathologic stage or lymph node(LN)status was assessed with the log-rank test.Multivariable Cox proportional hazard models were used to evaluate the association among OS,CSS and risk factors of interest.Results:Of 2098 patients who underwent RC,1243 patients underwent MIRC(1087 laparoscopic RC and 156 robotic-assisted RC,respectively),while 855 patients underwent ORC.No significant differences were noted in positive surgical margin rate and 90-day postoperative mortality rate.MIRC was associated with less estimated blood loss,more LN yield,higher rate of neobladder diversion,longer operative time,and longer length of hospital stay.There was no significant difference in OS and CSS according to surgical approaches(pZ0.653,and 0.816,respectively).Subgroup analysis revealed that OS and CSS were not significantly different regardless of the status of extravesical involvement or LN involvement.Multivariable Cox regression analyses showed that the surgical approach was not a significant predictor of OS and CSS.Conclusions:Our study showed that MIRC was comparable to conventional ORC in terms of OS and CSS. 关 键 词：Bladder cancer Radical cystectomy Minimally invasive surgery Robotic surgery LAPAROSCOPY
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