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11.04.2019 | Invited Review

Oncologic outcomes after robot-assisted versus open radical cystectomy: a systematic review and meta-analysis

verfasst von: Takehiro Iwata, Shoji Kimura, Beat Foerster, Nicola Fossati, Alberto Briganti, Pierre I. Karakiewicz, Kilian M. Gust, Shin Egawa, Yasutomo Nasu, Mohammad Abufaraj, Shahrokh F. Shariat

Erschienen in: World Journal of Urology | Ausgabe 8/2019

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Abstract

Purpose

The efficacy of RARC in oncologic outcomes compared ORC is controversial. We assess potential differences in oncologic outcomes between robot-assisted radical cystectomy (RARC) and open radical cystectomy (ORC).

Methods

We performed the literature search systematically according to the Preferred Reporting Items for Systematic Review and Meta-analysis statement. A pooled meta-analysis was performed to assess the difference in oncologic outcomes between RARC and ORC, separately in randomized controlled trials (RCTs) and non-randomized studies (NRCTs).

Results

Five RCTs and 28 NRCTs were included in this systematic review and meta-analysis. There was no difference in the rate of overall positive surgical margin (PSM) in RCTs, while NRCTs showed a lower rate for RARC. There was no difference in the soft tissue PSM rate between RARC and ORC in both RCTs and NRCTs. There was no difference in the lymph node yield by standard and extended lymph node dissection between RARC and ORC in both RCTs and NRCTs. There was no significant difference in survival outcomes between RARC and ORC in both RCTs and NRCTs.

Conclusions

Based on the current evidence, there is no difference in the rate of PSMs, lymph node yield, recurrence rate and location as well as short-term survival outcomes between RARC and ORC in RCTs. In NRCTs, only PSM rates were better for RARC compared to ORC, but this was likely due to selection and reporting bias which are inherent to retrospective study designs.

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Titel: Oncologic outcomes after robot-assisted versus open radical cystectomy: a systematic review and meta-analysis
verfasst von: Takehiro Iwata
Shoji Kimura
Beat Foerster
Nicola Fossati
Alberto Briganti
Pierre I. Karakiewicz
Kilian M. Gust
Shin Egawa
Yasutomo Nasu
Mohammad Abufaraj
Shahrokh F. Shariat
Publikationsdatum: 11.04.2019
Verlag: Springer Berlin Heidelberg
Erschienen in: World Journal of Urology / Ausgabe 8/2019
Print ISSN: 0724-4983
Elektronische ISSN: 1433-8726
DOI: https://doi.org/10.1007/s00345-019-02708-8

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Oncologic outcomes after robot-assisted versus open radical cystectomy: a systematic review and meta-analysis

Abstract

Purpose

Methods

Results

Conclusions

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