Clinical outcome of Laparoscopic and Robot-assisted Radical Cystectomy for Bladder Cancer in a Retrospective Study

Abstract Background: With the rapid development of surgical technics and instruments, more and more bladder cancer patients are being treated by laparoscopic radical cystectomy (LRC) and robot-assisted radical cystectomy (RARC) .The aim of this retrospective study was to compare the perioperative and long-term outcomes of patients who underwent cystectomy by these two surgical approaches. Methods: We performed a retrospective review of the prospectively collected database of our hospital to identify patients with clinical stage Ta/T1/Tis to T3 who underwent RARC and LRC. Perioperative outcomes, recurrence, and overall survival (OS) were analyzed. Results: From March 2010 to December 2019, there were total of 218 patients, which including 82(38%) patients with LRC and 136(62%) patients with RARC. No perioperative death was observed in both groups. Tumor recurrence, death from any causes, and cancer-specific death occurred in 77, 55, and 39 patients respectively. The 5-year DFS, OS, and CSS rates for all included patients were 55.4%, 62.4%, and 66.4%, respectively. There were no significantly statistically differences between the RARC group and the LRC group for number of lymph nodes harvested, positive lymph node rate, positive margin rate and postoperative pathological stage (all P>0.05). Patients undergoing RARC had lower median estimated blood loss (180mL vs. 250 mL; P 0.015) and 90-days postoperative complications (30.8% vs. 46.3%; P 0.013) than LRC.Conclusions: For selected patients with RARC and LRC, both were safe and effective with a low complication rate and similar long-term outcome compared two groups. Moreover, the robotic approach resulted in lower median estimated blood loss and better outcome in postoperative complications.