Long-Term Outcomes of Orthotopic Neobladder Versus Ileal Conduit Urinary Diversion in Robot-Assisted Radical Cystectomy (RARC): Multicenter Results from the Asian RARC Consortium
Issued Date
2024-01-01
Resource Type
ISSN
10689265
eISSN
15344681
Scopus ID
2-s2.0-85194837156
Pubmed ID
38802711
Journal Title
Annals of Surgical Oncology
Rights Holder(s)
SCOPUS
Bibliographic Citation
Annals of Surgical Oncology (2024)
Suggested Citation
Wong C.H.m., Ko I.C.h., Kang S.H., Kitamura K., Horie S., Muto S., Ohyama C., Hatakeyama S., Patel M., Yang C.K., Kijvikai K., Youl L.J., Chen H.G., Zhang R.Y., Lin T.X., Lee L.S., Teoh J.Y.c., Chan E. Long-Term Outcomes of Orthotopic Neobladder Versus Ileal Conduit Urinary Diversion in Robot-Assisted Radical Cystectomy (RARC): Multicenter Results from the Asian RARC Consortium. Annals of Surgical Oncology (2024). doi:10.1245/s10434-024-15396-5 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/98662
Title
Long-Term Outcomes of Orthotopic Neobladder Versus Ileal Conduit Urinary Diversion in Robot-Assisted Radical Cystectomy (RARC): Multicenter Results from the Asian RARC Consortium
Author's Affiliation
Sengkang General Hospital
Korea University Anam Hospital
Ramathibodi Hospital
Juntendo University Graduate School of Medicine
Renji Hospital
Hirosaki University
The University of Sydney
Prince of Wales Hospital Hong Kong
Sun Yat-Sen University
Veterans General Hospital-Taichung Taiwan
The Catholic University of Korea
Korea University Anam Hospital
Ramathibodi Hospital
Juntendo University Graduate School of Medicine
Renji Hospital
Hirosaki University
The University of Sydney
Prince of Wales Hospital Hong Kong
Sun Yat-Sen University
Veterans General Hospital-Taichung Taiwan
The Catholic University of Korea
Corresponding Author(s)
Other Contributor(s)
Abstract
Purpose: Robot-assisted radical cystectomy (RARC) has gained traction in the management of muscle invasive bladder cancer. Urinary diversion for RARC was achieved with orthotopic neobladder and ileal conduit. Evidence on the optimal method of urinary diversion was limited. Long-term outcomes were not reported before. This study was designed to compare the perioperative and oncological outcomes of ileal conduit versus orthotopic neobladder cases of nonmetastatic bladder cancer treated with RARC. Patients and Methods: The Asian RARC consortium was a multicenter registry involving nine Asian centers. Consecutive patients receiving RARC were included. Cases were divided into the ileal conduit and neobladder groups. Background characteristics, operative details, perioperative outcomes, recurrence information, and survival outcomes were reviewed and compared. Primary outcomes include disease-free and overall survival. Secondary outcomes were perioperative results. Multivariate regression analyses were performed. Results: From 2007 to 2020, 521 patients who underwent radical cystectomy were analyzed. Overall, 314 (60.3%) had ileal conduit and 207 (39.7%) had neobladder. The use of neobladder was found to be protective in terms of disease-free survival [Hazard ratio (HR) = 0.870, p = 0.037] and overall survival (HR = 0.670, p = 0.044) compared with ileal conduit. The difference became statistically nonsignificant after being adjusted in multivariate cox-regression analysis. Moreover, neobladder reconstruction was not associated with increased blood loss, nor additional risk of major complications. Conclusions: Orthotopic neobladder urinary diversion is not inferior to ileal conduit in terms of perioperative safety profile and long-term oncological outcomes. Further prospective studies are warranted for further investigation.