Oncologic Outcomes of Intracorporeal vs Extracorporeal Urinary Diversion After Robot-Assisted Radical Cystectomy: A Multi-Institutional Korean Study
- Authors
- Ham, Won Sik; Rha, Koon Ho; Han, Woong Kyu; Kwon, Tae Gyun; Kim, Tae Hwan; Jeon, Seung Hyun; Lee, Sang Hyup; Kang, Seok Ho; Kang, Sung Gu; Nam, Jong Kil; Kim, Wansuk; Jeong, Byung Chang; Ku, Ja Hyun; Oh, Jong Jin; Lee, Sang Chul; Lee, Ji Yeol; Hong, Sung Hoo; Lee, Young Goo; Lee, Yong Seong; Park, Sung Yul; Yoon, Young Eun; Kim, Jongchan
- Issue Date
- Oct-2021
- Publisher
- MARY ANN LIEBERT, INC
- Keywords
- urinary bladder neoplasm; robotic surgical procedure; cystectomy; urinary diversion
- Citation
- JOURNAL OF ENDOUROLOGY, v.35, no.10, pp 1490 - 1497
- Pages
- 8
- Journal Title
- JOURNAL OF ENDOUROLOGY
- Volume
- 35
- Number
- 10
- Start Page
- 1490
- End Page
- 1497
- URI
- https://scholarworks.bwise.kr/cau/handle/2019.sw.cau/74456
- DOI
- 10.1089/end.2021.0067
- ISSN
- 0892-7790
1557-900X
- Abstract
- Background: We aimed to compare the oncologic outcomes of intracorporeal urinary diversion (ICUD) and extracorporeal urinary diversion (ECUD) following robot-assisted radical cystectomy (RARC) in patients diagnosed with bladder cancer. Materials and Methods: Medical records of 730 patients who underwent RARC between April 2007 and May 2019 in 11 tertiary referral centers were retrospectively reviewed. We assessed recurrence-free survival (RFS), cancer-specific survival (CSS), and overall survival (OS) in the two groups using the Kaplan-Meier method. Cox regression models were used to identify factors associated with RFS, CSS, and OS. Results: Among 591 patients, neobladder diversion was performed more frequently in the ICUD group (70.8% vs 52.5%, p = 0.001). The median follow-up duration was shorter in the ICUD group than in the ECUD group (16 vs 26 months, p < 0.001). The rates of overall recurrence (36.5% vs 25.5%, p = 0.013) and pelvic recurrence (12.1% vs 5.9%, p = 0.031) were higher in the ECUD group. However, no differences in 5-year RFS (43.2% vs 58.4%, p = 0.516), CSS (79.3% vs 89.7%, p = 0.392), and OS (74.3% vs 81.4%, p = 0.411) were noted between the two groups. Multivariable analysis revealed that when compared to ICUD, ECUD was not associated with RFS (hazard ratio [HR], 0.982; p = 0.920), CSS (HR, 0.568; p = 0.126), and OS (HR, 0.642; p = 0.124). Conclusion: Although there was a difference in recurrence rate between the two groups, multivariable analysis indicated that the diversion technique after RARC did not affect the oncologic outcomes. Large prospective studies with long-term follow-up are warranted to verify the oncologic outcomes of ICUD and ECUD following RARC.
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