Annals of surgical oncology · 2026
Robot-Assisted Versus Open Bladder Cuff Excision After Radical Nephroureterectomy: A Multicenter Study by the French Urothelial Cancer Committee.
Сравнительное исследованиеСтатьяМногоцентровое исследованиеНаблюдательное исследованиеНазвание и аннотация: Перевод в очереди
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Gabriel Pierre-Etienne, Seisen Thomas, Xylinas Evanguelos, Duquesne Hugo, Marcq Gautier, Duquesne Igor, Bajeot Anne Sophie, Mercier Jérémy, Pradère Benjamin, Duffaut Louise, Panthier Frederic, Allory Yves, Audenet François, Leon Priscilla, Thibault Constance, Rouprêt Morgan, Roumiguié Mathieu, Masson-Lecomte Alexandra
Аннотация
BACKGROUND: The purpose of this study was to evaluate the oncological and perioperative outcomes of robot-assisted bladder cuff excision (RA-BCE) versus open bladder cuff excision (O-BCE) after radical nephroureterectomy (RNU) for patients with upper tract urothelial carcinoma (UTUC).
PATIENTS AND METHODS: We conducted a multicenter study including all consecutive patients who underwent RA-BCE or O-BCE in eight French academic institutions from 2014 to 2023. Kaplan-Meier curves were used to illustrate survival outcomes, while uni- and multivariable Cox regression analyses were conducted to identify independent predictors of survival by calculating hazard (HRs) ratios with their corresponding 95% confidence intervals (CIs).
RESULTS: Overall, 487 patients underwent either RA-BCE (n = 182; 37.4%) or O-BCE (n = 305; 62.6%). The median follow up was 30.1 (26.9-36) months. Kaplan-Meier analyses showed that the use of RA-BCE versus O-BCE was associated with similar 3-year intravesical recurrence-free survival (RFS) (68.9% vs. 59.7%; p = 0.1), 3-year extravesical RFS (69.2 vs. 63.8%; p = 0.2), 3-year cancer-specific survival (CSS) (85.5% vs. 76.2%; p = 0.08), and 3-year overall survival (OS) (76% vs. 67.6%; p = 0.1). Multivariable Cox regression analyses confirmed that the use of RA-BCE versus O-BCE was associated with similar 3-year intravesical recurrence (HR 0.83; 95% CI 0.55-1.26; p = 0.4), as well as similar 3-year extravesical recurrence (p = 0.8), 3-year CSS (p = 0.3), and 3-year OS (p = 0.3). Among 340 patients (69.8%) assessed, RA-BCE was associated with a lower rate of overall 90-day complications (p = 0.02), fewer major complications (p = 0.02), and a shorter length of stay (p < 0.01).
CONCLUSIONS: Our multicenter study supports the effectiveness of RA-BCE versus O-BCE in the treatment of UTUC with comparable 3-year oncological outcomes.
PATIENTS AND METHODS: We conducted a multicenter study including all consecutive patients who underwent RA-BCE or O-BCE in eight French academic institutions from 2014 to 2023. Kaplan-Meier curves were used to illustrate survival outcomes, while uni- and multivariable Cox regression analyses were conducted to identify independent predictors of survival by calculating hazard (HRs) ratios with their corresponding 95% confidence intervals (CIs).
RESULTS: Overall, 487 patients underwent either RA-BCE (n = 182; 37.4%) or O-BCE (n = 305; 62.6%). The median follow up was 30.1 (26.9-36) months. Kaplan-Meier analyses showed that the use of RA-BCE versus O-BCE was associated with similar 3-year intravesical recurrence-free survival (RFS) (68.9% vs. 59.7%; p = 0.1), 3-year extravesical RFS (69.2 vs. 63.8%; p = 0.2), 3-year cancer-specific survival (CSS) (85.5% vs. 76.2%; p = 0.08), and 3-year overall survival (OS) (76% vs. 67.6%; p = 0.1). Multivariable Cox regression analyses confirmed that the use of RA-BCE versus O-BCE was associated with similar 3-year intravesical recurrence (HR 0.83; 95% CI 0.55-1.26; p = 0.4), as well as similar 3-year extravesical recurrence (p = 0.8), 3-year CSS (p = 0.3), and 3-year OS (p = 0.3). Among 340 patients (69.8%) assessed, RA-BCE was associated with a lower rate of overall 90-day complications (p = 0.02), fewer major complications (p = 0.02), and a shorter length of stay (p < 0.01).
CONCLUSIONS: Our multicenter study supports the effectiveness of RA-BCE versus O-BCE in the treatment of UTUC with comparable 3-year oncological outcomes.