Laparoscopic Versus Open Radical Cystectomy in the Treatment of Locally Advanced T3 and T4 Bladder Cancer: Perioperative and Mid-term Oncological Outcomes

Overview

Journal Turk J Urol

Publisher Aves

Date 2020 Feb 14

PMID 32053094

Citations 2

Authors

Sinan Celen

Onur Kaygisiz

Hakan Vuruskan

Ismet Yavascaoglu

Affiliations

Soon will be listed here.

Abstract

Objective: In this study, we aim to compare the perioperative and midterm oncological outcomes in patients with advanced bladder cancer and those who had laparoscopic radical cystectomy (LRC) and open radical cystectomy (ORC).

Material And Methods: We retrospectively reviewed medical records of patients who underwent LRC or ORC in a single center between 2008 and 2014 with a pathological diagnosis of pT3 and pT4 bladder cancer. Thirty-five and 39 patients were included in the study as part of the LRC and ORC groups, respectively.

Results: There was no statistically significant difference between the two groups in terms of disease-free survival (LRC, 39.8±4.86 months; ORC, 45.47±8.92 months, P=0.896). Average estimated blood loss and length of hospitalization were significantly less in the LRC group. The overall survival rates of patients at 1, 2, and 3 years were 73%, 46%, and 46% in the ORC group and 78%, 65%, and 40% in the LRC group, respectively, and there was no statistically significant difference between the two groups. One patient in the ORC group experienced rectal injury in the form of a serosal tear, which was repaired primarily without any postoperative sequelae. There were no conversions in the laparoscopic group. Similarly, in 1 patient, rectal serosal tear was repaired preoperatively.

Conclusion: Our study showed that LRC provides midterm oncological outcomes similar to ORC in the treatment of locally advanced T3 and T4 bladder cancer. However, long-term oncological and functional outcomes are required.

Citing Articles

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Chen J, Gu Z, Pan Y, Zhang Y, Gu D Evid Based Complement Alternat Med. 2022; 2022:1681038.

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References

Basillote J, Abdelshehid C, Ahlering T, Shanberg A . Laparoscopic assisted radical cystectomy with ileal neobladder: a comparison with the open approach. J Urol. 2004; 172(2):489-93. DOI: 10.1097/01.ju.0000129662.83162.2e. View

Albisinni S, Rassweiler J, Abbou C, Cathelineau X, Chlosta P, Fossion L . Long-term analysis of oncological outcomes after laparoscopic radical cystectomy in Europe: results from a multicentre study by the European Association of Urology (EAU) section of Uro-technology. BJU Int. 2014; 115(6):937-45. DOI: 10.1111/bju.12947. View

Porpiglia F, Renard J, Billia M, Scoffone C, Cracco C, Terrone C . Open versus laparoscopy-assisted radical cystectomy: results of a prospective study. J Endourol. 2007; 21(3):325-9. DOI: 10.1089/end.2006.0224. View

Hadjizacharia P, Stein J, Cai J, Miranda G . The impact of positive soft tissue surgical margins following radical cystectomy for high-grade, invasive bladder cancer. World J Urol. 2008; 27(1):33-8. DOI: 10.1007/s00345-008-0345-1. View

Kubota H, Takahashi S, Monzawa S, Yuasa N, Endo T, Miura T . Pictorial review of orthotopic neobladder reconstruction: indication, normal postsurgical anatomy, and complications. Abdom Radiol (NY). 2016; 41(2):356-67. DOI: 10.1007/s00261-015-0576-8. View

Haber G, Gill I . Laparoscopic radical cystectomy for cancer: oncological outcomes at up to 5 years. BJU Int. 2007; 100(1):137-42. DOI: 10.1111/j.1464-410X.2007.06865.x. View

Hermans T, Fossion L . What about conventional laparoscopic radical cystectomy? Cost-analysis of open versus laparoscopic radical cystectomy. J Endourol. 2013; 28(4):410-5. DOI: 10.1089/end.2013.0550. View

Albisinni S, Oderda M, Fossion L, Varca V, Rassweiler J, Cathelineau X . The morbidity of laparoscopic radical cystectomy: analysis of postoperative complications in a multicenter cohort by the European Association of Urology (EAU)-Section of Uro-Technology. World J Urol. 2015; 34(2):149-56. DOI: 10.1007/s00345-015-1633-1. View

Tang K, Li H, Xia D, Hu Z, Zhuang Q, Liu J . Laparoscopic versus open radical cystectomy in bladder cancer: a systematic review and meta-analysis of comparative studies. PLoS One. 2014; 9(5):e95667. PMC: 4023936. DOI: 10.1371/journal.pone.0095667. View

10.

Haber G, Crouzet S, Gill I . Laparoscopic and robotic assisted radical cystectomy for bladder cancer: a critical analysis. Eur Urol. 2008; 54(1):54-62. DOI: 10.1016/j.eururo.2008.03.076. View

11.

Soria F, Moschini M, DAndrea D, Abufaraj M, Foerster B, Mathieu R . Comparative Effectiveness in Perioperative Outcomes of Robotic versus Open Radical Cystectomy: Results from a Multicenter Contemporary Retrospective Cohort Study. Eur Urol Focus. 2018; 6(6):1233-1239. DOI: 10.1016/j.euf.2018.11.002. View

12.

Guillotreau J, Game X, Mouzin M, Doumerc N, Mallet R, Sallusto F . Radical cystectomy for bladder cancer: morbidity of laparoscopic versus open surgery. J Urol. 2008; 181(2):554-9. DOI: 10.1016/j.juro.2008.10.011. View

13.

Zou X, Zhang G, Xue Y, Yuan Y, Xiao R, Wu G . Transumbilical multiport laparoscopic nephrectomy with specimen extraction through the vagina. Urol Int. 2014; 92(4):407-13. DOI: 10.1159/000356099. View

14.

Hautmann R . The oncologic results of laparoscopic radical cystectomy are not (yet) equivalent to open cystectomy. Curr Opin Urol. 2009; 19(5):522-6. DOI: 10.1097/MOU.0b013e32832d9564. View

15.

Hautmann R, Gschwend J, de Petriconi R, Kron M, Volkmer B . Cystectomy for transitional cell carcinoma of the bladder: results of a surgery only series in the neobladder era. J Urol. 2006; 176(2):486-92. DOI: 10.1016/j.juro.2006.03.038. View

16.

Hassan A, Raheem O, Berquist S, Beksac A, Bloch A, Field C . Comparison of laparoendoscopic single-site (LESS) and multiport laparoscopic radical nephrectomy for clinical T1b and T2a renal masses. Minerva Urol Nefrol. 2017; 69(6):596-603. DOI: 10.23736/S0393-2249.17.02785-0. View

17.

Sathianathen N, Kalapara A, Frydenberg M, Lawrentschuk N, Weight C, Parekh D . Robotic Assisted Radical Cystectomy vs Open Radical Cystectomy: Systematic Review and Meta-Analysis. J Urol. 2018; 201(4):715-720. DOI: 10.1016/j.juro.2018.10.006. View

18.

Gakis G, Efstathiou J, Lerner S, Cookson M, Keegan K, Guru K . ICUD-EAU International Consultation on Bladder Cancer 2012: Radical cystectomy and bladder preservation for muscle-invasive urothelial carcinoma of the bladder. Eur Urol. 2012; 63(1):45-57. DOI: 10.1016/j.eururo.2012.08.009. View

19.

Hemal A, Kolla S, Wadhwa P, Dogra P, Gupta N . Laparoscopic radical cystectomy and extracorporeal urinary diversion: a single center experience of 48 cases with three years of follow-up. Urology. 2008; 71(1):41-6. DOI: 10.1016/j.urology.2007.08.056. View

20.

Lin T, Fan X, Zhang C, Xu K, Liu H, Zhang J . A prospective randomised controlled trial of laparoscopic vs open radical cystectomy for bladder cancer: perioperative and oncologic outcomes with 5-year follow-upT Lin et al. Br J Cancer. 2014; 110(4):842-9. PMC: 3929868. DOI: 10.1038/bjc.2013.777. View