MP61-14 READMISSION RATES AND THEIR PREDICTORS AFTER ROBOTIC AND OPEN RADICAL CYSTECTOMY

Abstract

INTRODUCTION AND OBJECTIVE: Radical cystectomy (RC) remains a surgery that has significant perioperative complication rates. Robot-assisted RC (RARC) was envisaged as a technique allowing for lower complication rates and readmissions when compared to open cystectomy (OC) and retrospective studies support this. We evaluated readmission rates at 90 days and 1 year following RC in patients from the RAZOR trial; a multicenter, open-label non-inferiority phase III randomized trial comparing RARC to OC. METHODS: The per-protocol population of the RAZOR trial was used for analysis. Readmission rates at 90 days and 1 year were tabulated using the RAZOR database. Frailty was evaluated by the validated simplified frailty index (sFI) (ECOG≥2, history of diabetes mellitus, chronic obstructive pulmonary disease, congestive cardiac failure, and hypertension requiring treatment). Multivariable logistic regression analysis was conducted to identify factors predicting readmission at both time points postoperatively. RESULTS: Readmission rates at 90 days were 24% for RARC and 23% for ORC (p=0.842). At 1 year the respective rates were 29.3% for RARC and 28.3% for ORC (p=0.841). sFI ³3 was a significant predictor of readmission at both time points (OR 6.05, 1.79-20.48, p=0.004 at 90days and OR 9.55, 1.69-53.77, p=0.011 at 1 year). Surgical approach (RARC or ORC), diversion type, lymphadenectomy, age, sex, T or N stage, and BMI were not predictive of readmission (Table 1). CONCLUSIONS: Postoperative readmission rates do not differ between RARC and ORC in this prospective analysis from the RAZOR trial. sFI was the only identifiable factor predicting readmission and surgical approach, diversion, chemotherapy, lymphadenectomy, etc. were not significant predictors. This data suggests that patient factors like frailty contribute significantly to recovery from a major procedure like RC. This study provides important prospective data for patient counseling and reiterates the importance of prospective trials to evaluate different surgical techniques before drawing conclusions regarding readmission rates.Source of Funding: The RAZOR trial was supported by the National Institutes of Health (NIH) National Cancer Institute (NCI; grant number 5RO1CA155388).