Login to Access Video or Poster Abstract: MP54-06
Sources of Funding: None

Introduction

Robotic-assisted radical cystectomy (RARC) has become increasingly utilized in treatment of muscle-invasive bladder cancer, yet the limited data to support its oncologic efficacy comes largely from high volume centers. RARC represents a technically demanding procedure, and results may not be reproducible across multiple surgeons and institutions. We aim to assess the effect of center volume on survival outcomes in patients undergoing RARC.

Methods

Using the National Cancer Data Base (NCDB) we identified patients undergoing RARC from 2010-2012. Center volume was defined by the number of RARC performed over the study period. Low volume centers were defined by <10 RARC, representing the lowest tertile. Univariable and multivariable regression modeling was used to identify patient and disease variables, including RARC volume, associated with overall and additional treatment-free survival.

Results

Of the 2,773 patients that underwent RARC, 975 (35%) died during follow-up. 948 RARC were performed at &[Prime]low volume centers&[Prime] (table 1). On multivariable analysis (table 2), age >80 years (HR 1.91, 95% CI 1.06-3.43, p=0.03), stage (vs. 10) was independently associated with both overall (HR 0.74, 95% CI 0.59-0.93, p<0.01) and additional treatment free survival (HR 0.66 95% CI 0.49-0.88, p<0.01)._x000D_

Conclusions

Accounting for disease and hospital related variables, patients undergoing RARC at low volume centers had worse overall and additional treatment free survival. This suggests that adequate center volume may be important for conferring surgical quality and ultimately survival outcomes.

Funding

None