New evidence suggests that patients undergoing robotic-assisted radical cystectomy for non-metastatic bladder cancer experience better response in terms of days alive and out of the hospital than patients undergoing open radical cystectomy. The robotic approach was associated with improved post-operative mobilization, decreased transfusion requirement and reduced burden on perceived quality of life.
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References
Chang, S. S. et al. Treatment of non-metastatic muscle-invasive bladder cancer: AUA/ASCO/ASTRO/SUO Guideline. J. Urol. 198, 552–559 (2017).
Novara, G. et al. Systematic review and cumulative analysis of perioperative outcomes and complications after robot-assisted radical cystectomy. Eur. Urol. 67, 376–401 (2015).
Zamboni, S. et al. Differences in trends in the use of robot-assisted and open radical cystectomy and changes over time in peri-operative outcomes among selected centres in North America and Europe: an international multicentre collaboration. BJU Int. https://doi.org/10.1111/bju.14791 (2019).
Mortezavi, A. et al. Association of open vs robot-assisted radical cystectomy with mortality and perioperative outcomes among patients with bladder cancer in Sweden. JAMA Netw. Open 5, e228959 (2022).
Sathianathen, N. J. et al. Robotic assisted radical cystectomy vs open radical cystectomy: systematic review and meta-analysis. J. Urol. 201, 715–720 (2019).
Bochner, B. H. et al. Comparing open radical cystectomy and robot-assisted laparoscopic radical cystectomy: a randomized clinical trial. Eur. Urol. 67, 1042–1050 (2015).
Bochner, B. H. et al. Randomized trial comparing open radical cystectomy and robot-assisted laparoscopic radical cystectomy: oncologic outcomes. Eur. Urol. 74, 465–471 (2018).
Parekh, D. J. et al. Robot-assisted radical cystectomy versus open radical cystectomy in patients with bladder cancer (RAZOR): an open-label, randomised, phase 3, non-inferiority trial. Lancet 391, 2525–2536 (2018).
Catto, J. W. F. et al. Effect of robot-assisted radical cystectomy with intracorporeal urinary diversion vs open radical cystectomy on 90-day morbidity and mortality among patients with bladder cancer: a randomized clinical trial. JAMA 327, 2092–2103 (2022).
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S.P.L. declares the following competing interests: clinical trials — Endo, FKD, JBL (SWOG), Genentech (SWOG), QED Therapeutics, UroGen, Vaxiion and Viventia; consultant/advisory board — Aura Bioscience, BMS, C2i Genomics, FerGene, Genentech, Pfizer/EMD Serono, Stimit, UroGen, Vaxiion and Verity; patent — TCGA classifier; and honoraria — Annenberg, Clinical Care Options, Grand Rounds Urology, Ology and UroToday. S.R.P. declares no competing interests.
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Patel, S.R., Lerner, S.P. Evolving the surgical approach for bladder cancer — robotic versus open radical cystectomy. Nat Rev Urol 20, 203–204 (2023). https://doi.org/10.1038/s41585-022-00704-z
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DOI: https://doi.org/10.1038/s41585-022-00704-z