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31.07.2023 | Original Article

Long-term oncologic and functional outcomes following robot-assisted radical cystectomy and intracorporeal Padua ileal bladder: results from a single high-volume center

verfasst von: Gabriele Tuderti, Riccardo Mastroianni, Giuseppe Chiacchio, Umberto Anceschi, Alfredo Maria Bove, Aldo Brassetti, Mariaconsiglia Ferriero, Leonardo Misuraca, Rocco Simone Flammia, Flavia Proietti, Simone D’Annunzio, Costantino Leonardo, Salvatore Guaglianone, Marianna Anselmi, Ashanti Zampa, Andrea Benedetto Galosi, Giulia Torregiani, Michele Gallucci, Giuseppe Simone

Erschienen in: World Journal of Urology | Ausgabe 9/2023

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Abstract

Purpose

To report long-term oncologic and functional outcomes of a large consecutive single center series of Robot-assisted radical cystectomy (RARC)- intracorporeal (IC) Urinary Diversion (UD), identifying their predicting factors.

Methods

A single center Bladder cancer (BC) database was queried for “RARC” and “ICUD”, including patients treated between January 2012 and September 2020. Kaplan–Meier curves were assessed disease-free (DFS), cancer-specific (CSS) and overall survival (OS) probability. Univariable (UV) and multivariable (MV) analysis were adopted to identify predictors of DFS, CSS and OS. Kaplan–Meier method evaluated day- and night-time continence recovery probabilities; UV and MV analysis were adopted to identify predictors of Day-time continence.

Results

Overall, 251 patients were included. Among them, 192 patients underwent intracorporeal ileal orthotopic neobladder (ION) (76.5%). Five-year DFS, CSS and OS rates were 66.5%, 65.4% and 61.5%; pT stage ≥ 3 and pathologic nodal involvement were identified as negative independent predictors of DFS (HR 2.39, p = 0.001, HR 4.64, p ≤ 0.001), CSS (HR 2.20, p = 0.01, HR 3.97, p < 0.001) and OS (HR 2.25, p = 0.005, HR 3.95, p < 0.001). In RARC-ION patients, Trifecta rate was 64.1%. One-year day- and night-time continence rates were 78.6% and 48.3%. Age (HR 0.98, p = 0.03), female gender (HR 0.57, p = 0.008) and complications Clavien grade ≥ 3 (HR 0.55, p = 0.03) were identified as independent predictors of day-time incontinence.

Conclusions

Long-term oncologic outcomes and their predicting factors seem aligned to the largest historical open series and multi-institutional robotic series data. According to the identified predicting factors undermining a proper achievement of day-time continence, this represents an objective support, in order to properly advice specific sub-group of patients.

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Titel: Long-term oncologic and functional outcomes following robot-assisted radical cystectomy and intracorporeal Padua ileal bladder: results from a single high-volume center
verfasst von: Gabriele Tuderti
Riccardo Mastroianni
Giuseppe Chiacchio
Umberto Anceschi
Alfredo Maria Bove
Aldo Brassetti
Mariaconsiglia Ferriero
Leonardo Misuraca
Rocco Simone Flammia
Flavia Proietti
Simone D’Annunzio
Costantino Leonardo
Salvatore Guaglianone
Marianna Anselmi
Ashanti Zampa
Andrea Benedetto Galosi
Giulia Torregiani
Michele Gallucci
Giuseppe Simone
Publikationsdatum: 31.07.2023
Verlag: Springer Berlin Heidelberg
Erschienen in: World Journal of Urology / Ausgabe 9/2023
Print ISSN: 0724-4983
Elektronische ISSN: 1433-8726
DOI: https://doi.org/10.1007/s00345-023-04523-8

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Long-term oncologic and functional outcomes following robot-assisted radical cystectomy and intracorporeal Padua ileal bladder: results from a single high-volume center