MP72-17 RADICAL CYSTECTOMY PRACTICES AMONG URO-ONCOLOGISTS: A STATE OF THE ART SURVEY

Abstract

You have accessJournal of UrologyBladder Cancer: Invasive V1 Apr 2015MP72-17 RADICAL CYSTECTOMY PRACTICES AMONG URO-ONCOLOGISTS: A STATE OF THE ART SURVEY Evan Kovac, Kamran Zargar-Shoshtari, Homayoun Zargar, Cesar Ercole, and Andrew Stephenson Evan KovacEvan Kovac More articles by this author , Kamran Zargar-ShoshtariKamran Zargar-Shoshtari More articles by this author , Homayoun ZargarHomayoun Zargar More articles by this author , Cesar ErcoleCesar Ercole More articles by this author , and Andrew StephensonAndrew Stephenson More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.02.2651AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Radical cystectomy (RC) and its associated peri-operative care and techniques have evolved substantially over the past two decades. We endeavored to determine the state of the art by conducting a survey investigating RC practices among Society of Urologic Oncology members. METHODS An 11-question survey was sent to members of the Society of Urologic Oncology via email. Questions focused on RC patient selection practices, the use of open and/or robotic platforms, preferred use of peri-operative chemotherapy, preferred lymph node dissection (LND) templates and peri-operative patient preparation and management, including the use of Enhanced Recovery After Surgery (ERAS) principles. All responses were collected and analyzed by year of graduation from residency, and further stratified by either “robotic/open” surgeon or “open only” surgeon. RESULTS This survey was sent to 663 email addresses and was opened by 226. 79 surveys were completed, for a 35% response rate. 75.6% of respondents practice in an academic setting, with the remaining in a non-academic setting. For those that regularly perform RC in their routine clinical practice, 51.4% employ the robotic platform to perform the procedure. There was no difference in the use of the robotic platform to perform RC among recent residency graduates (after 2000) and non-recent graduates (before 2000) (60% vs. 41%, respectively, p=0.161). Among robotic/open surgeons, 89.7% reported they perform an extracorporeal urinary diversion; 94.9% perform RC on appropriately selected octogenarians; 82.1% and 100% stated they offer patients neoadjuvant chemotherapy to cT2 and >cT3 patients, respectively; 87% and 100% offer adjuvant chemotherapy to pT3 and N+ patients, respectively; 60% and 40% perform LND superiorly to the aortic bifurcation and dissect pre-sacral nodes, respectively, while nearly 100% employ ERAS principles. No major differences in clinical and operative practices were noted between “robotic/open” surgeons and “open only” surgeons, except in the use of ERAS principles, of which “robotic/open” surgeons utilized significantly more. CONCLUSIONS The use of the robotic platform is increasingly used among uro-oncologists for performing RC. The use of peri-operative chemotherapy, extended LND, and patient selection to include octogenarians is common among all uro-oncologists, while those that employ the robotic platform utilize ERAS principles more regularly. This survey gives insight into the state of the art management of muscle invasive bladder cancer among uro-oncologists. © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 193Issue 4SApril 2015Page: e927 Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.MetricsAuthor Information Evan Kovac More articles by this author Kamran Zargar-Shoshtari More articles by this author Homayoun Zargar More articles by this author Cesar Ercole More articles by this author Andrew Stephenson More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...