Abstract: PD67-08
Sources of Funding: none

Introduction

There is currently lack of sufficient data on the long-term oncological outcomes after robot-assisted radical cystectomy.The aim of this study is to compare the long-term oncological outcomes of robot-assisted with open radical cystectomy.

Methods

We retrospectively analysed the oncological outcomes of robot-assisted (RARC) versus open radical cystectomy (ORC) from prospectively collected database, between 2003 and 2011 to evaluate recurrence free (RFS) and cancer specific survival (CSS). Data including patient age, gender post-operative histology and time to recurrence were collected prospectively and analysed using the Kaplan Meier method and log rank testing. Patients were stratified as having organ confined (?pT2) or non-organ confined (?pT3 or LN+ve) disease.

Results

A total of 182 patients were identified during the study period: 65 (men 53, women 12) underwent RARC and 117 (men 82, women 35) patients had an ORC. Median age was 67 (35-82) and the median follow up for all the cases was 55.5 months (range 3-154months). Histologically-proven organ-confined disease was found in 74% of RARC patients compared with 59% of patients having ORC. Positive margins were reported in 4/65 (6%) RARC cases compared with 7/117 (5.98%) open cases. Median lymph node yield was similar for both surgical approaches (11 for ORC vs 10 for RARC), but the percentage of positive LNs was higher in the ORC group (17% vs 8%). _x000D_ Overall, 37% (24/65) of RARC patients and 41% (48/117) of ORC patients developed recurrence. For organ-confined disease, 5-year RFS was 75% vs 74.9% for RARC and ORC respectively. This difference was not statistically different (p= 0.7435). For non-organ confined disease 5 year RFS was 39.2% vs 31.2% for RARC and ORC respectively. This difference was statistically non-significant (p= 0.89)._x000D_ For patients with organ confined disease, there was no statistically significant difference in 5-year CSS between RARC and ORC (84% and 82.6% respectively, p=0.74). There was also no significant difference in 5-year CSS between RARC and ORC for non-organ confined disease (39% and 38.9% respectively, p=0.85)._x000D_

Conclusions

This data shows that the long term oncological outcomes of open vs robot assisted cystectomy are equivalent. Thus technology is unlikely to have significant impact on oncological outcomes.

Funding

none