Minimally Invasive Versus Open Approach for Cystectomy: Trends in the Utilization and Demographic or Clinical Predictors Using the National Cancer Database (Ncdb)

Abstract Objectives To examine temporal national trends of operative approach for cystectomy and identify demographic or clinical predictive factors that influence choice of approach. Methods We performed a retrospective cohort study of patients who underwent cystectomy for bladder cancer between 20...

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Published in:Urology (Ridgewood, N.J.) N.J.), 2017-05, Vol.103, p.99-105
Main Authors: Bachman, Andrew G., BA, Parker, Alexander A., BS, Shaw, Marshall D., MD, Cross, Brian W., MD, Stratton, Kelly L., MD, Cookson, Michael S., MD, Patel, Sanjay G., MD
Format: Article
Language:English
Subjects:
Aged
American Cancer Society
Cystectomy - methods
Cystectomy - trends
Databases, Factual
Female
Humans
Male
Medicaid
Minimally Invasive Surgical Procedures - trends
Multivariate Analysis
Regression Analysis
Retrospective Studies
Robotic Surgical Procedures
Societies, Medical
Time Factors
United States
Urinary Bladder Neoplasms - surgery
Urology
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Summary:Abstract Objectives To examine temporal national trends of operative approach for cystectomy and identify demographic or clinical predictive factors that influence choice of approach. Methods We performed a retrospective cohort study of patients who underwent cystectomy for bladder cancer between 2010 and 2013 using the National Cancer Database (NCDB). Approach was stratified by open vs. minimally invasive (robotic or laparoscopic). Univariate Pearson chi-square and multivariate logistic regression analysis was used to assess relationships between demographic and hospital factors and the receipt of minimally invasive or open surgical approach. Results A total of 9439 patients met our inclusion criteria, of which 34.1% received a minimally invasive approach (MIA). Frequency of MIA increased from 26.3% in 2010 to 39.4% in 2013 (p< 0.0001). Univariate analysis identified statistically significant associations between year of diagnosis, sex, age, race, clinical T stage, insurance status, income, education, distance from hospital, facility type, geographic location, and facility cystectomy volume and choice of approach (all p
ISSN:0090-4295
1527-9995
DOI:10.1016/j.urology.2017.02.018