Evolution of Perioperative Outcomes in Robot-Assisted Radical Cystectomy over 20 Years of Experience in a High-Volume Tertiary Robotic Center.

IF 4.4 2区医学 Q1 ONCOLOGY

Cancers Pub Date : 2025-09-19 DOI:10.3390/cancers17183060

Simone Morra, Stefano Resca, Nicola Frego, Sara Tamburini, Marco Ticonosco, Alessandro Pissavini, Andrea Noya Mourullo, Francesco Barletta, Mario de Angelis, Edward Lambert, Frederiek D'Hondt, Ruben De Groote, Geert De Naeyer, Alexandre Mottrie

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引用次数: 0

Abstract

Background/objectives: Robot-assisted radical cystectomy (RARC) has demonstrated improved perioperative outcomes and recovery in bladder cancer (BCa) patients. This study compares patient and tumor characteristics, operative time (OT), length of stay (LOS), and complication rates between a historical (2003-2016) and a contemporary cohort (2017-2024) treated at a high-volume robotic center.

Methods: Data from 274 BCa patients who underwent RARC at AZORG Hospital, Aalst, Belgium, were analyzed. Perioperative outcomes were compared between cohorts. Multivariable Poisson regression models identified predictors of longer OT and LOS, while multivariable logistic regression models (MLRMs) assessed predictors of higher complication rates.

Results: Overall, 274 BCa patients who underwent RARC were identified (38% historical cohort vs. 62% contemporary cohort). The contemporary cohort had a significantly shorter median OT (345 vs. 360 min; p = 0.048) and LOS (8 vs. 12 days; p < 0.001) compared to the historical cohort. Postoperative complications were lower in the contemporary group, with more cases experiencing no complications (60% vs. 41%) and fewer grade 3-4 complications (10% vs. 27%; p < 0.001). In multivariable Poisson regression, the contemporary cohort was an independent predictor of shorter OT (Incidence Rate Ratio [IRR]: 0.94, 95% [Confidence Interval] CI: 0.93-0.96; p = 0.04) and shorter LOS (IRR: 0.65, 95% CI: 0.60-0.69; p < 0.001). In MLRMs predicting complications, the contemporary cohort was associated with lower risk (Odds Ratio: 0.42, 95% CI: 0.23-0.76; p = 0.005).

Conclusions: RARC outcomes improved significantly over time, with reduced OT, LOS, and complication rates in the contemporary cohort, highlighting advancements in surgical techniques, perioperative care, and patient safety. These findings reinforce the role of RARC in optimizing BCa treatment.

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查看原文本刊更多论文

机器人辅助根治性膀胱切除术围手术期预后的演变在一个大容量三级机器人中心超过20年的经验。

背景/目的：机器人辅助根治性膀胱切除术（RARC）改善了膀胱癌（BCa）患者的围手术期预后和康复。本研究比较了历史（2003-2016年）和当代（2017-2024年）在大容量机器人中心治疗的患者和肿瘤特征、手术时间（OT）、住院时间（LOS）和并发症发生率。方法：分析在比利时Aalst AZORG医院接受RARC治疗的274例BCa患者的资料。比较两组患者的围手术期结果。多变量泊松回归模型确定了更长的OT和LOS的预测因素，而多变量logistic回归模型（mlrm）评估了更高并发症发生率的预测因素。结果：总体而言，274例BCa患者接受了RARC（38%的历史队列对62%的当代队列）。与历史队列相比，当代队列的中位OT （345 vs 360分钟，p = 0.048）和LOS （8 vs 12天，p < 0.001）显著缩短。当代组的术后并发症较低，无并发症的病例较多（60%比41%），3-4级并发症较少（10%比27%，p < 0.001）。在多变量泊松回归中，当代队列是较短的OT（发病率比[IRR]: 0.94, 95%[置信区间]CI: 0.93-0.96; p = 0.04）和较短的LOS （IRR: 0.65, 95% CI: 0.60-0.69; p < 0.001）的独立预测因子。在预测并发症的MLRMs中，当代队列与较低的风险相关（优势比：0.42,95% CI: 0.23-0.76; p = 0.005）。结论：RARC结果随着时间的推移显著改善，当代队列中OT、LOS和并发症发生率降低，突出了手术技术、围手术期护理和患者安全方面的进步。这些发现强化了RARC在优化BCa治疗中的作用。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Cancers Medicine-Oncology

CiteScore

8.00

自引率

9.60%

发文量

5371

审稿时长

18.07 days

期刊介绍： Cancers (ISSN 2072-6694) is an international, peer-reviewed open access journal on oncology. It publishes reviews, regular research papers and short communications. Our aim is to encourage scientists to publish their experimental and theoretical results in as much detail as possible. There is no restriction on the length of the papers. The full experimental details must be provided so that the results can be reproduced.