TY  - JOUR
A1  - Höh, Robert Benedikt
A1  - Flammia, Rocco Simone
A1  - Hohenhorst, Lukas
A1  - Sorce, Gabriele
A1  - Chierigo, Francesco
A1  - Panunzio, Andrea
A1  - Tian, Zhe
A1  - Saad, Fred
A1  - Gallucci, Michele
A1  - Briganti, Alberto
A1  - Terrone, Carlo
A1  - Shariat, Shahrokh F.
A1  - Graefen, Markus
A1  - Tilki, Derya
A1  - Antonelli, Alessandro
A1  - Kluth, Luis
A1  - Becker, Andreas
A1  - Chun, Felix
A1  - Karakiewicz, Pierre I.
T1  - Outcomes of robotic-assisted versus open radical cystectomy in a large-scale, contemporary cohort of bladder cancer patients
T2  - Journal of surgical oncology
N2  - Background and Objectives: To test for differences in perioperative outcomes and total hospital costs (THC) in nonmetastatic bladder cancer patients undergoing open (ORC) versus robotic-assisted radical cystectomy (RARC).
Methods: We relied on the National Inpatient Sample database (2016–2019). Statistics consisted of trend analyses, multivariable logistic, Poisson, and linear regression models.
Results: Of 5280 patients, 1876 (36%) versus 3200 (60%) underwent RARC versus ORC. RARC increased from 32% to 41% (estimated annual percentage change [EAPC]: + 8.6%; p = 0.02). Rates of transfusion (8% vs. 16%), intraoperative (2% vs. 3%), wound (6% vs. 10%), and pulmonary (6% vs. 10%) complications were lower in RARC patients (all p < 0.05). Moreover, median length of stay (LOS) was shorter in RARC (6 vs. 7days; p < 0.001). Conversely, median THC (31,486 vs. 27,162$; p < 0.001) were higher in RARC. Multivariable logistic regression-derived odds ratios addressing transfusion (0.49), intraoperative (0.53), wound (0.68), and pulmonary (0.71) complications favored RARC (all p < 0.01). In multivariable Poisson and linear regression models, RARC was associated with shorter LOS (Rate ratio:0.86; p < 0.001), yet higher THC (Coef.:5,859$; p < 0.001). RARC in-hospital mortality was lower (1% vs. 2%; p = 0.04).
Conclusions: RARC complications, LOS, and mortality appear more favorable than ORC, but result in higher THC. The favorable RARC profile contributes to its increasing popularity throughout the United States.
KW  - bladder cancer
KW  - complication
KW  - open
KW  - outcomes
KW  - radical cystectomy
KW  - robotic-assisted
Y1  - 2022
UR  - http://publikationen.ub.uni-frankfurt.de/frontdoor/index/index/docId/72285
UR  - https://nbn-resolving.org/urn:nbn:de:hebis:30:3-722857
SN  - 1096-9098
N1  - Open Access funding enabled and organized by Projekt DEAL.
N1  - All data generated for this study were from the National Inpatient Sample (NIS) database. The code for the analyses will be made available upon request.
VL  - 126
IS  - 4
SP  - 830
EP  - 837
PB  - Wiley
CY  - Bognor Regis [u.a.]
ER  -