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Long-term oncologic outcomes of robot-assisted radical cystectomy (RARC) with totally intracorporeal urinary diversion (ICUD): a multi-center study

Brassetti, Aldo ; Cacciamani, Giovanni ; Anceschi, Umberto ; Ferriero, Mariaconsiglia ; Tuderti, Gabriele ; Miranda, Gus ; Mastroianni, Riccardo ; Desai, Mihir ; Aron, Monish ; Gill, Inderbir ; Gallucci, Michele ; Simone, Giuseppe

World journal of urology, April 2020, Vol.38(4), pp.837-843 [Rivista Peer Reviewed]

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  • Titolo:
    Long-term oncologic outcomes of robot-assisted radical cystectomy (RARC) with totally intracorporeal urinary diversion (ICUD): a multi-center study
  • Autore: Brassetti, Aldo ; Cacciamani, Giovanni ; Anceschi, Umberto ; Ferriero, Mariaconsiglia ; Tuderti, Gabriele ; Miranda, Gus ; Mastroianni, Riccardo ; Desai, Mihir ; Aron, Monish ; Gill, Inderbir ; Gallucci, Michele ; Simone, Giuseppe
  • Note di contenuto: To report survival outcomes after robot-assisted radical cystectomy (RARC) with intracorporeal urinary diversion (ICUD) for recurrent/muscle-invasive non-metastatic bladder cancer. Prospectively maintained databases were queried for "robotic cystectomy AND ICUD". Patients treated after October 2013 and those treated without curative intent were excluded. Kaplan-Meier method was used to plot stage-specific survival outcomes, computed at 1, 2, and 5 years after surgery. Univariable and multivariable Cox analyses assessed predictors of recurrence-free (RFS), cancer-specific (CSS) and overall (OS) survival. 113 consecutive patients were included, mostly men (82%). Neoadjuvant chemotherapy was performed in 23% of cases, median lymph node (LN) yield was 36 (IQR 28-45) and the rate of positive surgical margins (PSM) was 8%. Orthotopic ileal neobladder was the preferred ICUD type (57%). An organ-confined disease was observed in 51% of cases and 21% were pT0 on final histology. Overall, 5-year RFS, CSS and OS probabilities were 58 ± 5%, 61 ± 5% and 54 ± 5%, respectively. At Kaplan-Meier method, tumor stage group was a significant predictor of survival probabilities (all p < 0.001) and this was confirmed at multivariable Cox regression analysis (RFS-OR 2.29; 95% CI 1.58-3.32; p < 0.001) (CSS-OR 1.82; 95% CI 1.3-2.53; p < 0.001) (OS-OR 2.14; 95% CI 1.46-3.14; p < 0.001). PSM status was associated to CSS (OR 2.54; 95% CI 1.13-5.69; p = 0.024) and OS (OR 2.82; 95% CI 1.17-6.77; p = 0.021), but did not predict RFS (p = 0.062).
  • Fa parte di: World journal of urology, April 2020, Vol.38(4), pp.837-843
  • Soggetti: Bladder Cancer ; Long-Term Outcomes ; Radical Cystectomy ; Robotic ; Survival ; Urothelial Carcinoma
  • Lingua: Inglese
  • Tipo: Articolo
  • Identificativo: E-ISSN: 1433-8726 ; PMID: 31190152 Version:1 ; DOI: 10.1007/s00345-019-02842-3

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