Abstract
What’s known on the subject? and What does the study add? It is known that the lymph node yield in open cystectomy is variable and dependent, in some part, upon surgeon experience.This study, the largest of its kind reporting on outcomes associated with robot‐assisted radical cystectomy, demonstrates that lymph node yields in experienced hands at the time of robot‐assisted radical cystectomy is comparable to that seen in open series.OBJECTIVETo evaluate the incidence of, and predictors for, lymphadenectomy in patients undergoing robot‐assisted radical cystectomy (RARC) for bladder cancer.PATIENTS AND METHODSUtilizing the International Robotic Cystectomy Consortium (IRCC) database, 527 patients were identified who underwent RARC at 15 institutions from 2003 to 2009. After stratification by age group, sex, pathological T stage, nodal status, sequential case number, institutional volume and surgeon volume, logistic regression was used to correlate variables to the likelihood of undergoing lymphadenectomy (defined as ≥10 nodes removed).RESULTSOf the 527 patients, 437 (82.9%) underwent lymphadenectomy. A mean of 17.8 (range 0–68) lymph nodes were examined. Tumour stage, sequential case number, institution volume and surgeon volume were significantly associated with the likelihood of undergoing lymphadenectomy. Surgeon volume was most significantly associated with lymphadenectomy on multivariate analysis. High‐volume surgeons (>20 cases) were almost three times more likely to perform lymphadenectomy than lower‐volume surgeons, all other variables being constant [odds ratio (OR) = 2.37; 95% confidence interval (CI) = 1.39–4.05; P= 0.002].CONCLUSIONThe rates of lymphadenectomy at RARC for advanced bladder cancer are similar to those of open cystectomy series using a large, multi‐institutional cohort. There does, however, appear to be a learning curve associated with the performance of lymphadenectomy at RARC.
Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
