MP23-02 EARLY ONCOLOGIC OUTCOMES OF OPEN VS ROBOT-ASSISTED RADICAL CYSTECTOMY WITH TOTALLY INTRACORPOREAL URINARY DIVERSION: SINGLE CENTRE PROSPECTIVE RANDOMISED CONTROLLED TRIAL

Abstract

You have accessJournal of UrologyCME1 May 2022MP23-02 EARLY ONCOLOGIC OUTCOMES OF OPEN VS ROBOT-ASSISTED RADICAL CYSTECTOMY WITH TOTALLY INTRACORPOREAL URINARY DIVERSION: SINGLE CENTRE PROSPECTIVE RANDOMISED CONTROLLED TRIAL Riccardo Mastroianni, Gabriele Tuderti, Umberto Anceschi, Alfredo Maria Bove, Aldo Brassetti, Mariaconsiglia Ferriero, Leonardo Misuraca, Salvatore Guaglianone, Michele Gallucci, and Giuseppe Simone Riccardo MastroianniRiccardo Mastroianni More articles by this author , Gabriele TudertiGabriele Tuderti More articles by this author , Umberto AnceschiUmberto Anceschi More articles by this author , Alfredo Maria BoveAlfredo Maria Bove More articles by this author , Aldo BrassettiAldo Brassetti More articles by this author , Mariaconsiglia FerrieroMariaconsiglia Ferriero More articles by this author , Leonardo MisuracaLeonardo Misuraca More articles by this author , Salvatore GuaglianoneSalvatore Guaglianone More articles by this author , Michele GallucciMichele Gallucci More articles by this author , and Giuseppe SimoneGiuseppe Simone More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002562.02AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Radical Cystectomy (RC) with urinary diversion (UD) is still considered a complex surgery associated with significant morbidity. Open radical cystectomy (ORC) remains the reference option of treatment, even if adoption of robot-assisted RC (RARC) is rapidly increasing. Two-yrs oncologic outcomes proved to be predictive of long term oncologic outcomes in historical series. In this study, we assessed early oncologic outcomes from a randomised controlled trial (RCT) comparing ORC and RARC with totally intracorporeal (i) urinary diversion (UD) (Clinical Trials: NCT03434132). METHODS: Institutional review board approval was obtained. Patients were eligible for randomization if they had a diagnostic TURBt with cT2-4, cN0, cM0, or recurrent HG NMIBC and no anesthesiologic contraindications to robotic surgery. Between January 2018 and September 2020, patients were enrolled with a covariate adaptive randomization process based on the following variables: BMI, ASA score, preoperative haemoglobin, UD (Padua ileal bladder or ileal conduit), neoadiuvant chemotherapy and cT-stage. Aim of this study was to evaluate oncologic outcomes: overall survival (OS), cancer specific survival (CSS), disease free survival (DFS) and metastasis free survival (MFS). Continuous and categorical variables were compared using Student t and Chi-Square tests, respectively. Kaplan-Meier (KM) method and the log-rank test were applied to assess survival outcomes. RESULTS: Overall, 116 patients were enrolled (RARC: 58 vs ORC: 58). Both groups were homogeneous for all clinical features (all p >0.15) (Tab.1). In the robotic group, UD was performed in all cases with a totally intracorporeal approach, with no need of open conversion. Pathologic data were reported (Tab.2). Overall, 23 (19.9%) patients had a high-risk non-muscle invasive BC. Homogeneous distribution of cT stages was confirmed at final pT-stages (p=0.78) and pN-stages (p=0.91). Soft tissue surgical margins were negative in all cases. Two patients were lost to follow-up, one for each arm. At a median follow-up of 22 mo (IQR 15-31), KM analysis displayed comparable OS, CSS, DFS and MFS probabilities (Fig.1). CONCLUSIONS: This RCT confirms comparable oncologic outcomes between ORC and RARC with totally iUD. Source of Funding: none © 2022 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 207Issue Supplement 5May 2022Page: e380 Advertisement Copyright & Permissions© 2022 by American Urological Association Education and Research, Inc.MetricsAuthor Information Riccardo Mastroianni More articles by this author Gabriele Tuderti More articles by this author Umberto Anceschi More articles by this author Alfredo Maria Bove More articles by this author Aldo Brassetti More articles by this author Mariaconsiglia Ferriero More articles by this author Leonardo Misuraca More articles by this author Salvatore Guaglianone More articles by this author Michele Gallucci More articles by this author Giuseppe Simone More articles by this author Expand All Advertisement PDF downloadLoading ...