Introduction:
There is paucity of evidence on the long-term oncological outcomes of robotic versus open radical cystectomy. This study aims to provide evidence on patient’s oncological outcomes.
Method and materials:
We retrospectively analysed the oncological outcomes of RARC versus ORC between 2003-2011. Patients were divided into organ-confined (≤pT2) or non-organ confined (≥pT3/LN+ve) disease. Recurrence-free (RFS) and cancer-specific survival (CSS) were evaluated using Kaplan-Meier and Log-rank testing.
Results: A total of 182 patients were identified: 65 underwent RARC and 117 had ORC. Median age was 67years (range35-82) and median follow-up was 55.5months (range3-154). In 74% of RARC and 59% of ORC patients, disease was organ-confined. Margins were positive in 6%(4/65) RARC versus 5.98% (7/117) in ORC. Median lymph node yield was similar for both approaches (11 for ORC vs 10 for RARC), but positive LNs was higher in the ORC group (17% vs 8%).
Overall, 37% (24/65) of RARC and 41% (48/117) of ORC patients developed recurrence. For organ-confined disease, 5-year RFS between RARC and ORC (75% vs 74.9%). The difference was statistically non-significant (p=0.7435). For non-organ confined disease 5-year RFS was 39.2% vs 31.2% for RARC and ORC respectively. This difference was statistically non-significant (p=0.89).
For organ-confined disease, 5-year CSS between RARC and ORC (84% and 82.6%) was non-significant (p=0.74). Similarly, for non-organ confined disease 5-year CSS between RARC and ORC (39% and 38.9%) was non-significant (p=0.85).
Conclusion: This data shows that the long-term oncological outcomes of RARC and ORC are equivalent. Thus, technology is unlikely to have a significant impact on oncological outcomes.