Open Versus Robotic Cystectomy: A Propensity Score Matched Analysis Comparing Survival Outcomes
Abstract
:1. Introduction
2. Experimental Section
2.1. Patients and Methods
2.2. Primary and Secondary End Points
2.3. Statistical Analyses
3. Results
3.1. Clinicopathologic Characteristics (Entire Cohort)
3.2. Clinicopathologic Characteristics (Adjusted Cohort)
3.3. Survival Analyses in the Entire Cohort (Unadjusted Cohort)
3.4. Survival Analyses after Propensity Matching (Adjusted Cohort)
4. Discussion
5. Conclusions
Author Contributions
Acknowledgments
Conflicts of Interest
References
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Variables | Overall (n = 9757, 100%) | RARC (n = 767, 7.8%) | ORC (n = 8990, 92%) | p Value |
---|---|---|---|---|
Age, years | ||||
Mean | 67 | 67 | 67 | 0.2 |
Median (IQR) | 68 (60–74) | 68 (62–74) | 68 (60–74) | |
Gender | ||||
Male | 7775 (79%) | 612 (80%) | 7163 (80%) | 0.9 |
Female | 1981 (20%) | 115 (20%) | 1827 (20%) | |
Neoadjuvant chemotherapy | 520 (5.3%) | 198 (26%) | 322 (3.6%) | <0.001 |
Pathological T stage | ||||
pT0-pT1 | 2908 (31%) | 368 (48%) | 2540 (29%) | <0.001 |
pT2 | 2239 (24%) | 93 (12%) | 2146 (25%) | |
pT3-pT4 | 4248 (45%) | 305 (40%) | 3943 (46%) | |
High grade | 8734 (94%) | 361 (76%) | 8373 (94%) | <0.001 |
LNI | 2276 (24%) | 158 (22%) | 2118 (24%) | 0.001 |
Nodes removed, number | ||||
Mean | 20 | 21 | 20 | 0.001 |
Median (IQR) | 16 (10–26) | 20 (13–28) | 16 (9–25) | |
Positive surgical margins | 639 (6.7%) | 107 (10.0%) | 532 (6.3%) | <0.001 |
LVI | 3007 (33%) | 25 (27%) | 2982 (34%) | 0.2 |
Adjuvant chemotherapy | 1828 (19%) | 85 (13%) | 1743 (20.9%) | <0.001 |
Variables | Overall (n = 1374, 100%) | RARC (n = 420, 33%) | ORC (n = 840, 67%) | p Value |
---|---|---|---|---|
Age, years | ||||
Mean | 66 | 66 | 66 | 0.9 |
Median (IQR) | 67 (59–73) | 67 (61–72) | 67 (51–72) | |
Gender | ||||
Male | 1003 (80%) | 365 (80%) | 728 (79%) | 0.9 |
Female | 257 (20%) | 93 (20%) | 188 (21%) | |
Neoadjuvant chemotherapy | 456 (33%) | 1162 (35%) | 294 (32%) | 0.2 |
Pathological T stage | ||||
pT0-pT1 | 535 (39%) | 189 (41%) | 346 (38%) | 0.4 |
pT2 | 208 (15%) | 52 (11%) | 156 (17%) | |
pT3-pT4 | 631 (46%) | 217 (47%) | 414 (52%) | |
High grade | 1075 (78%) | 348 (76%) | 727 (79%) | 0.1 |
Nodes removed, number | ||||
Mean | 19 | 22 | 17 | 0.001 |
Median (IQR) | 16 (10–25) | 19 (14–28) | 14 (8–24) | |
LNI | 318 (23%) | 109 (24%) | 209 (23%) | 0.6 |
Positive surgical margins | 115 (8.4%) | 52 (11%) | 63 (7.0%) | 0.006 |
LVI | 302 (32%) | 23 (45%) | 282 (32%) | 0.04 |
Adjuvant chemotherapy | 211 (16%) | 45 (12%) | 166 (18%) | 0.004 |
Variables | Overall Recurrence | CSM | ||
---|---|---|---|---|
HR (CI 95%) | p Value | HR (CI 95%) | p Value | |
Gender (male vs. female) | 1.07 (0.97–1.17) | 0.1 | 1.15 (1.04–1.27) | 0.005 |
Age, years | 1.00 (0.99–1.00) | 0.5 | 1.00 (0.99–1.00) | 0.052 |
RARC approach | 0.65 (0.34–1.26) | 0.2 | 1.00 (0.45–2.24) | 0.9 |
pT stage | ||||
pT0-pT1 | Ref | Ref | Ref | Ref |
pT2 | 1.35 (1.18–1.55) | <0.001 | 1.49 (1.27–1.73) | <0.001 |
pT3-4 | 2.10 (1.84–2.40) | <0.001 | 2.62 (2.27–3.03) | <0.001 |
pN+ | 1.68 (1.51–1.86) | <0.001 | 2.09 (1.88–2.33) | <0.001 |
Nodes removed | 0.99 (0.99–1.00) | 0.3 | 0.99 (0.99–1.00) | 0.04 |
High grade vs. low | 2.53 (1.73–3.71) | <0.001 | 2.37 (1.56–3.60) | <0.001 |
LVI | 1.44 (1.31–1.57) | <0.001 | 1.33 (1.21–1.46) | <0.001 |
Positive surgical margins | 1.43 (1.25–1.65) | <0.001 | 1.64 (1.42–1.90) | <0.001 |
Neoadjuvant chemotherapy | 1.69 (1.36–2.10) | <0.001 | 1.45 (1.15–1.85) | 0.002 |
Adjuvant chemotherapy | 1.18 (1.06–1.31) | 0.001 | 0.89 (0.80–0.99) | 0.03 |
Variables | Overall Recurrence | CSM | ||
---|---|---|---|---|
HR (CI 95%) | p Value | HR (CI 95%) | p Value | |
Gender (male vs. female) | 1.09 (0.80–1.48) | 0.6 | 1.23 (0.91–1.67) | 0.1 |
Age, years | 1.00 (0.99–1.01) | 0.5 | 1.01 (0.99–1.02) | 0.09 |
RARC approach | 0.76 (0.39–1.47) | 0.4 | 1.34 (0.49–2.36) | 0.8 |
pT stage | ||||
pT0-1 | Ref | Ref | Ref | Ref |
pT2 | 1.21 (0.77–1.90) | 0.3 | 1.34 (0.84–2.15) | 0.2 |
pT3-4 | 1.57 (1.04–2.37) | 0.03 | 2.17 (1.40–3.35) | <0.001 |
pN+ | 1.43 (1.05–1.94) | 0.02 | 2.33 (1.71–3.16) | <0.001 |
Nodes removed | 0.99 (0.98–1.00) | 0.3 | 0.98 (0.97–0.99) | 0.01 |
High grade vs. low | 3.20 (1.55–6.59) | 0.002 | 3.60 (1.62–7.98) | 0.002 |
LVI | 1.85 (1.37–2.49) | <0.001 | 1.27 (0.96–1.70) | 0.09 |
Positive surgical margins | 1.12 (0.74–1.69) | 0.5 | 1.30 (0.84–2.01) | 0.2 |
Neoadjuvant chemotherapy | 1.96 (1.51–2.54) | <0.001 | 1.34 (1.02–1.76) | 0.03 |
Adjuvant chemotherapy | 1.29 (0.94–1.77) | 0.1 | 0.77 (0.56–1.06) | 0.1 |
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Moschini, M.; Zamboni, S.; Soria, F.; Mathieu, R.; Xylinas, E.; Tan, W.S.; Kelly, J.D.; Simone, G.; Meraney, A.; Krishna, S.; et al. Open Versus Robotic Cystectomy: A Propensity Score Matched Analysis Comparing Survival Outcomes. J. Clin. Med. 2019, 8, 1192. https://doi.org/10.3390/jcm8081192
Moschini M, Zamboni S, Soria F, Mathieu R, Xylinas E, Tan WS, Kelly JD, Simone G, Meraney A, Krishna S, et al. Open Versus Robotic Cystectomy: A Propensity Score Matched Analysis Comparing Survival Outcomes. Journal of Clinical Medicine. 2019; 8(8):1192. https://doi.org/10.3390/jcm8081192
Chicago/Turabian StyleMoschini, Marco, Stefania Zamboni, Francesco Soria, Romain Mathieu, Evanguelos Xylinas, Wei Shen Tan, John D Kelly, Giuseppe Simone, Anoop Meraney, Suprita Krishna, and et al. 2019. "Open Versus Robotic Cystectomy: A Propensity Score Matched Analysis Comparing Survival Outcomes" Journal of Clinical Medicine 8, no. 8: 1192. https://doi.org/10.3390/jcm8081192