Pathologic measures of quality compare favorably in patients undergoing robot-assisted radical cystectomy to open cystectomy cohorts: a National Cancer Database analysis

This study aims to assess the impact of facility characteristics on measures of surgical quality (positive surgical margin rates and lymph-node yield) in patients undergoing robot-assisted (RARC) versus open (ORC) radical cystectomy using the National Cancer Database. Patients who received RC betwee...

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Bibliographic Details
Published in:Journal of robotic surgery 2020-08, Vol.14 (4), p.609-614
Main Authors: Miguel, Carla M., Kosinski, Kaitlin E., Fazzari, Melissa J., Kongnyuy, Michael, Smaldone, Marc C., Schiff, Jeffrey T., Katz, Aaron E., Corcoran, Anthony T.
Format: Article
Language:English
Subjects:
Bladder cancer
Cancer
Cancer therapies
Community centers
Dissection
Histology
Hospitals
Lymphatic system
Medicine
Medicine & Public Health
Minimally Invasive Surgery
Original Article
Patients
Regression models
Robotic surgery
Surgery
Trends
Urological surgery
Urology
Variables
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Summary:This study aims to assess the impact of facility characteristics on measures of surgical quality (positive surgical margin rates and lymph-node yield) in patients undergoing robot-assisted (RARC) versus open (ORC) radical cystectomy using the National Cancer Database. Patients who received RC between the years of 2010–2013 were stratified according to surgery type (ORC vs. RARC), and corresponding patient and facility-level variables (facility type and volume) were assessed. Logistic regression models for procedure type, positive surgical margins (PSMs), and LN dissection (LND) rates were estimated. Radical cystectomies (ORC = 13,236, RARC = 3687) were performed more often in academic centers (58.3%) compared to community centers (31.6%). As facility volume increased, centers performed more LNDs during ORCs ( p  = 0.03) and the number of nodes retrieved increased in both ORC and RARC (ORC p  
ISSN:1863-2483
1863-2491
DOI:10.1007/s11701-019-01031-z