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Outcomes of robotic‐assisted versus open radical cystectomy in a large‐scale, contemporary cohort of bladder cancer patients
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). Statis...
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| Published in: | Journal of surgical oncology 2022-09, Vol.126 (4), p.830-837 |
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| creator | Hoeh, Benedikt Flammia, Rocco S. Hohenhorst, Lukas Sorce, Gabriele Chierigo, Francesco Panunzio, Andrea Tian, Zhe Saad, Fred Gallucci, Michele Briganti, Alberto Terrone, Carlo Shariat, Shahrokh F. Graefen, Markus Tilki, Derya Antonelli, Alessandro Kluth, Luis A. Becker, Andreas Chun, Felix K. H. Karakiewicz, Pierre I. |
| description | 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 |
| doi_str_mv | 10.1002/jso.26973 |
| format | article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2673594544</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2700311439</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3883-20b9eef537d6679bf9b52e8b0c2e72d7c65379144cc1f6f3e28c4daffe6838bf3</originalsourceid><addsrcrecordid>eNp1kc1O3DAURi1EVQbaBS-ALLEpEgH_xYmXaAQtCGkWbdeW41xDRkkcbIdqdjwCz9gnwXSgi0pdXV19x0fX-hA6pOSMEsLO19GfMakqvoMWlChZKKLqXbTIGStEpcge2o9xTQhRSoqPaI-XUlIu6QI9reZk_QARe4eDb3zq7O-nZxNjFxO0-BFCnHM4wYiDaTtremw3ObLJDxvcjdjg3oQ7yI9iDuEUWz8mGCYfTNjk5d6H9CpvetO2ELA1o81jMqmDMcVP6IMzfYTPb_MA_by6_LH8Vtyuvl4vL24Ly-uaF4w0CsCVvGqlrFTjVFMyqBtiGVSsrazMkaJCWEuddBxYbUVrnANZ87px_AB92Xqn4B9miEkPXbTQ92YEP0fNZMVLJUohMnr8D7r2cxjzdZpVhHBKBVeZOtlSNvgYAzg9hW7If9aU6NdadK5F_6kls0dvxrkZoP1LvveQgfMt8KvrYfN_k775vtoqXwD5uJsm</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2700311439</pqid></control><display><type>article</type><title>Outcomes of robotic‐assisted versus open radical cystectomy in a large‐scale, contemporary cohort of bladder cancer patients</title><source>Wiley-Blackwell Read & Publish Collection</source><creator>Hoeh, Benedikt ; Flammia, Rocco S. ; Hohenhorst, Lukas ; Sorce, Gabriele ; Chierigo, Francesco ; Panunzio, Andrea ; Tian, Zhe ; Saad, Fred ; Gallucci, Michele ; Briganti, Alberto ; Terrone, Carlo ; Shariat, Shahrokh F. ; Graefen, Markus ; Tilki, Derya ; Antonelli, Alessandro ; Kluth, Luis A. ; Becker, Andreas ; Chun, Felix K. H. ; Karakiewicz, Pierre I.</creator><creatorcontrib>Hoeh, Benedikt ; Flammia, Rocco S. ; Hohenhorst, Lukas ; Sorce, Gabriele ; Chierigo, Francesco ; Panunzio, Andrea ; Tian, Zhe ; Saad, Fred ; Gallucci, Michele ; Briganti, Alberto ; Terrone, Carlo ; Shariat, Shahrokh F. ; Graefen, Markus ; Tilki, Derya ; Antonelli, Alessandro ; Kluth, Luis A. ; Becker, Andreas ; Chun, Felix K. H. ; Karakiewicz, Pierre I.</creatorcontrib><description><![CDATA[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.]]></description><identifier>ISSN: 0022-4790</identifier><identifier>EISSN: 1096-9098</identifier><identifier>DOI: 10.1002/jso.26973</identifier><identifier>PMID: 35661361</identifier><language>eng</language><publisher>United States: Wiley Subscription Services, Inc</publisher><subject>Bladder cancer ; complication ; Cystectomy - adverse effects ; Hospital costs ; Humans ; open ; outcomes ; Postoperative Complications - etiology ; radical cystectomy ; Regression analysis ; Robotic Surgical Procedures ; robotic‐assisted ; Treatment Outcome ; Urinary Bladder ; Urinary Bladder Neoplasms</subject><ispartof>Journal of surgical oncology, 2022-09, Vol.126 (4), p.830-837</ispartof><rights>2022 The Authors. published by Wiley Periodicals LLC.</rights><rights>2022 The Authors. Journal of Surgical Oncology published by Wiley Periodicals LLC.</rights><rights>2022. This article is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3883-20b9eef537d6679bf9b52e8b0c2e72d7c65379144cc1f6f3e28c4daffe6838bf3</citedby><cites>FETCH-LOGICAL-c3883-20b9eef537d6679bf9b52e8b0c2e72d7c65379144cc1f6f3e28c4daffe6838bf3</cites><orcidid>0000-0002-3129-0544 ; 0000-0002-4238-6584</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/35661361$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Hoeh, Benedikt</creatorcontrib><creatorcontrib>Flammia, Rocco S.</creatorcontrib><creatorcontrib>Hohenhorst, Lukas</creatorcontrib><creatorcontrib>Sorce, Gabriele</creatorcontrib><creatorcontrib>Chierigo, Francesco</creatorcontrib><creatorcontrib>Panunzio, Andrea</creatorcontrib><creatorcontrib>Tian, Zhe</creatorcontrib><creatorcontrib>Saad, Fred</creatorcontrib><creatorcontrib>Gallucci, Michele</creatorcontrib><creatorcontrib>Briganti, Alberto</creatorcontrib><creatorcontrib>Terrone, Carlo</creatorcontrib><creatorcontrib>Shariat, Shahrokh F.</creatorcontrib><creatorcontrib>Graefen, Markus</creatorcontrib><creatorcontrib>Tilki, Derya</creatorcontrib><creatorcontrib>Antonelli, Alessandro</creatorcontrib><creatorcontrib>Kluth, Luis A.</creatorcontrib><creatorcontrib>Becker, Andreas</creatorcontrib><creatorcontrib>Chun, Felix K. H.</creatorcontrib><creatorcontrib>Karakiewicz, Pierre I.</creatorcontrib><title>Outcomes of robotic‐assisted versus open radical cystectomy in a large‐scale, contemporary cohort of bladder cancer patients</title><title>Journal of surgical oncology</title><addtitle>J Surg Oncol</addtitle><description><![CDATA[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.]]></description><subject>Bladder cancer</subject><subject>complication</subject><subject>Cystectomy - adverse effects</subject><subject>Hospital costs</subject><subject>Humans</subject><subject>open</subject><subject>outcomes</subject><subject>Postoperative Complications - etiology</subject><subject>radical cystectomy</subject><subject>Regression analysis</subject><subject>Robotic Surgical Procedures</subject><subject>robotic‐assisted</subject><subject>Treatment Outcome</subject><subject>Urinary Bladder</subject><subject>Urinary Bladder Neoplasms</subject><issn>0022-4790</issn><issn>1096-9098</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>24P</sourceid><recordid>eNp1kc1O3DAURi1EVQbaBS-ALLEpEgH_xYmXaAQtCGkWbdeW41xDRkkcbIdqdjwCz9gnwXSgi0pdXV19x0fX-hA6pOSMEsLO19GfMakqvoMWlChZKKLqXbTIGStEpcge2o9xTQhRSoqPaI-XUlIu6QI9reZk_QARe4eDb3zq7O-nZxNjFxO0-BFCnHM4wYiDaTtremw3ObLJDxvcjdjg3oQ7yI9iDuEUWz8mGCYfTNjk5d6H9CpvetO2ELA1o81jMqmDMcVP6IMzfYTPb_MA_by6_LH8Vtyuvl4vL24Ly-uaF4w0CsCVvGqlrFTjVFMyqBtiGVSsrazMkaJCWEuddBxYbUVrnANZ87px_AB92Xqn4B9miEkPXbTQ92YEP0fNZMVLJUohMnr8D7r2cxjzdZpVhHBKBVeZOtlSNvgYAzg9hW7If9aU6NdadK5F_6kls0dvxrkZoP1LvveQgfMt8KvrYfN_k775vtoqXwD5uJsm</recordid><startdate>20220901</startdate><enddate>20220901</enddate><creator>Hoeh, Benedikt</creator><creator>Flammia, Rocco S.</creator><creator>Hohenhorst, Lukas</creator><creator>Sorce, Gabriele</creator><creator>Chierigo, Francesco</creator><creator>Panunzio, Andrea</creator><creator>Tian, Zhe</creator><creator>Saad, Fred</creator><creator>Gallucci, Michele</creator><creator>Briganti, Alberto</creator><creator>Terrone, Carlo</creator><creator>Shariat, Shahrokh F.</creator><creator>Graefen, Markus</creator><creator>Tilki, Derya</creator><creator>Antonelli, Alessandro</creator><creator>Kluth, Luis A.</creator><creator>Becker, Andreas</creator><creator>Chun, Felix K. H.</creator><creator>Karakiewicz, Pierre I.</creator><general>Wiley Subscription Services, Inc</general><scope>24P</scope><scope>WIN</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>K9.</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-3129-0544</orcidid><orcidid>https://orcid.org/0000-0002-4238-6584</orcidid></search><sort><creationdate>20220901</creationdate><title>Outcomes of robotic‐assisted versus open radical cystectomy in a large‐scale, contemporary cohort of bladder cancer patients</title><author>Hoeh, Benedikt ; Flammia, Rocco S. ; Hohenhorst, Lukas ; Sorce, Gabriele ; Chierigo, Francesco ; Panunzio, Andrea ; Tian, Zhe ; Saad, Fred ; Gallucci, Michele ; Briganti, Alberto ; Terrone, Carlo ; Shariat, Shahrokh F. ; Graefen, Markus ; Tilki, Derya ; Antonelli, Alessandro ; Kluth, Luis A. ; Becker, Andreas ; Chun, Felix K. H. ; Karakiewicz, Pierre I.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3883-20b9eef537d6679bf9b52e8b0c2e72d7c65379144cc1f6f3e28c4daffe6838bf3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Bladder cancer</topic><topic>complication</topic><topic>Cystectomy - adverse effects</topic><topic>Hospital costs</topic><topic>Humans</topic><topic>open</topic><topic>outcomes</topic><topic>Postoperative Complications - etiology</topic><topic>radical cystectomy</topic><topic>Regression analysis</topic><topic>Robotic Surgical Procedures</topic><topic>robotic‐assisted</topic><topic>Treatment Outcome</topic><topic>Urinary Bladder</topic><topic>Urinary Bladder Neoplasms</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Hoeh, Benedikt</creatorcontrib><creatorcontrib>Flammia, Rocco S.</creatorcontrib><creatorcontrib>Hohenhorst, Lukas</creatorcontrib><creatorcontrib>Sorce, Gabriele</creatorcontrib><creatorcontrib>Chierigo, Francesco</creatorcontrib><creatorcontrib>Panunzio, Andrea</creatorcontrib><creatorcontrib>Tian, Zhe</creatorcontrib><creatorcontrib>Saad, Fred</creatorcontrib><creatorcontrib>Gallucci, Michele</creatorcontrib><creatorcontrib>Briganti, Alberto</creatorcontrib><creatorcontrib>Terrone, Carlo</creatorcontrib><creatorcontrib>Shariat, Shahrokh F.</creatorcontrib><creatorcontrib>Graefen, Markus</creatorcontrib><creatorcontrib>Tilki, Derya</creatorcontrib><creatorcontrib>Antonelli, Alessandro</creatorcontrib><creatorcontrib>Kluth, Luis A.</creatorcontrib><creatorcontrib>Becker, Andreas</creatorcontrib><creatorcontrib>Chun, Felix K. H.</creatorcontrib><creatorcontrib>Karakiewicz, Pierre I.</creatorcontrib><collection>Wiley-Blackwell Open Access Collection</collection><collection>Wiley-Blackwell Backfiles (Open access)</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of surgical oncology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Hoeh, Benedikt</au><au>Flammia, Rocco S.</au><au>Hohenhorst, Lukas</au><au>Sorce, Gabriele</au><au>Chierigo, Francesco</au><au>Panunzio, Andrea</au><au>Tian, Zhe</au><au>Saad, Fred</au><au>Gallucci, Michele</au><au>Briganti, Alberto</au><au>Terrone, Carlo</au><au>Shariat, Shahrokh F.</au><au>Graefen, Markus</au><au>Tilki, Derya</au><au>Antonelli, Alessandro</au><au>Kluth, Luis A.</au><au>Becker, Andreas</au><au>Chun, Felix K. H.</au><au>Karakiewicz, Pierre I.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Outcomes of robotic‐assisted versus open radical cystectomy in a large‐scale, contemporary cohort of bladder cancer patients</atitle><jtitle>Journal of surgical oncology</jtitle><addtitle>J Surg Oncol</addtitle><date>2022-09-01</date><risdate>2022</risdate><volume>126</volume><issue>4</issue><spage>830</spage><epage>837</epage><pages>830-837</pages><issn>0022-4790</issn><eissn>1096-9098</eissn><abstract><![CDATA[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.]]></abstract><cop>United States</cop><pub>Wiley Subscription Services, Inc</pub><pmid>35661361</pmid><doi>10.1002/jso.26973</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0002-3129-0544</orcidid><orcidid>https://orcid.org/0000-0002-4238-6584</orcidid><oa>free_for_read</oa></addata></record> |
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| ispartof | Journal of surgical oncology, 2022-09, Vol.126 (4), p.830-837 |
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| source | Wiley-Blackwell Read & Publish Collection |
| subjects | Bladder cancer complication Cystectomy - adverse effects Hospital costs Humans open outcomes Postoperative Complications - etiology radical cystectomy Regression analysis Robotic Surgical Procedures robotic‐assisted Treatment Outcome Urinary Bladder Urinary Bladder Neoplasms |
| title | Outcomes of robotic‐assisted versus open radical cystectomy in a large‐scale, contemporary cohort of bladder cancer patients |
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