Oncologic outcomes after robot-assisted versus open radical cystectomy: a systematic review and meta-analysis

被引：15

作者：

Iwata, Takehiro ^{[1
,2
,3
]}

Kimura, Shoji ^{[1
,2
,4
]}

Foerster, Beat ^{[1
,2
,5
]}

Fossati, Nicola ^{[6
]}

Briganti, Alberto ^{[6
]}

Karakiewicz, Pierre I. ^{[7
]}

Gust, Kilian M. ^{[1
,2
]}

Egawa, Shin ^{[4
]}

Nasu, Yasutomo ^{[3
]}

Abufaraj, Mohammad ^{[1
,2
,8
]}

Shariat, Shahrokh F. ^{[1
,2
,9
,10
,11
,12
]}

机构：

[1] Med Univ Vienna, Vienna Gen Hosp, Dept Urol, Wahringer Gurtel 18-20, A-1090 Vienna, Austria

[2] Med Univ Vienna, Vienna Gen Hosp, Comprehens Canc Ctr, Wahringer Gurtel 18-20, A-1090 Vienna, Austria

[3] Okayama Univ, Grad Sch Med Dent & Pharmaceut Sci, Dept Urol, Okayama, Japan

[4] Jikei Univ, Sch Med, Dept Urol, Tokyo, Japan

[5] Kantonsspital Winterthur, Dept Urol, Winterthur, Switzerland

[6] IRCCS Osped San Raffaele, URI, Unit Urol, Div Oncol, Milan, Italy

[7] Univ Montreal, Hlth Ctr, Canc Prognost & Hlth Outcomes Unit, Div Urol, Montreal, PQ, Canada

[8] Univ Jordan, Jordan Univ Hosp, Dept Special Surg, Amman, Jordan

[9] Weill Cornell Med Coll, Dept Urol, New York, NY 10065 USA

[10] Univ Texas Southwestern Med Ctr Dallas, Dept Urol, Dallas, TX 75390 USA

[11] Karl Landsteiner Inst Urol & Androl, Vienna, Austria

[12] IM Sechenov First Moscow State Med Univ, Insitute Urol & Reprod Hlth, Moscow, Russia

来源：

WORLD JOURNAL OF UROLOGY | 2019年 / 37卷 / 08期

关键词：

Oncologic outcome; Open radical cystectomy; Positive surgical margin; Robot-assisted radical cystectomy; INVASIVE BLADDER-CANCER; PERIOPERATIVE OUTCOMES; NEOADJUVANT CHEMOTHERAPY; RECURRENCE; IMPACT; RISK; CYSTOPROSTATECTOMY; LYMPHADENECTOMY; COMPLICATIONS; POPULATION;

D O I：

10.1007/s00345-019-02708-8

中图分类号：

R5 [内科学]; R69 [泌尿科学（泌尿生殖系疾病）];

学科分类号：

1002 ; 100201 ;

摘要：

Purpose The efficacy of RARC in oncologic outcomes compared ORC is controversial. We assess potential differences in oncologic outcomes between robot-assisted radical cystectomy (RARC) and open radical cystectomy (ORC). Methods We performed the literature search systematically according to the Preferred Reporting Items for Systematic Review and Meta-analysis statement. A pooled meta-analysis was performed to assess the difference in oncologic outcomes between RARC and ORC, separately in randomized controlled trials (RCTs) and non-randomized studies (NRCTs). Results Five RCTs and 28 NRCTs were included in this systematic review and meta-analysis. There was no difference in the rate of overall positive surgical margin (PSM) in RCTs, while NRCTs showed a lower rate for RARC. There was no difference in the soft tissue PSM rate between RARC and ORC in both RCTs and NRCTs. There was no difference in the lymph node yield by standard and extended lymph node dissection between RARC and ORC in both RCTs and NRCTs. There was no significant difference in survival outcomes between RARC and ORC in both RCTs and NRCTs. Conclusions Based on the current evidence, there is no difference in the rate of PSMs, lymph node yield, recurrence rate and location as well as short-term survival outcomes between RARC and ORC in RCTs. In NRCTs, only PSM rates were better for RARC compared to ORC, but this was likely due to selection and reporting bias which are inherent to retrospective study designs.

引用

页码：1557 / 1570

页数：14

共 56 条

[1] Quality of Lymphadenectomy is Equivalent With Robotic and Open Cystectomy Using an Extended Template [J].