Comparison of open and laparoscopic radical cystectomy as regards long-term oncological outcomes for bladder cancer

Authors

  • Thanachai Sirikul Division of Urology, Department of Surgery, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
  • Supon Sriplakich Division of Urology, Department of Surgery, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
  • Akara Amantakul Division of Urology, Department of Surgery, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand

DOI:

https://doi.org/10.52786/isu.a.34

Keywords:

Radical cystectomy, laparoscopic, open, bladder cancer, long-term, oncological outcome

Abstract

Objective: Recently, the laparoscopic technique has become widely accepted as a minimally invasive modality which reduces morbidity and provides similar oncological outcomes to open surgery. However, the number of clinical trials comparing laparoscopic and open radical cystectomy are limited. The objectives of this study are to compare the long-term oncological outcomes between open radical cystectomy (ORC) and laparoscopic radical cystectomy (LRC) for bladder cancer.

Materials and Methods: Out of 144 radical cystectomy patients admitted to our institute from January 2006 to December 2016, 87 patients were categorized as being in the LRC group, and 57 patients in the ORC group. Baseline characteristics, perioperative variables, and pathology results were collected retrospectively. Oncological outcomes including overall survival (OS), recurrence-free survival (RFS) and cancer-specific survival (CSS) were analyzed and compared between the two groups.

Results: The mean age of the patients was 64.19 ± 9.89 years in the ORC group and 61.90 ± 10.47 years in the LRC group. The most frequent urinary diversion procedure in both groups was ileal conduit. All pathology results between the LRC group and the ORC group showed no statistical significance. The median follow-up duration was 57.18 ± 44.68 months in the ORC group and 53.96 ± 34.97 months in the LRC group. There was no statistically significant difference in overall survival (OS), recurrence-free survival (RFS) and cancer-specific survival (CSS) between the groups (p = 0.322, 0.946, and 0.528, respectively).

Conclusion: Our study demonstrated that the long-term oncological outcome of LRC is comparable to ORC in the management of bladder cancer. LRC is an alternative option to open radical cystectomy and is safe, effective, and feasible. However, further large comparative studies with adequate long-term follow-up are recommended to support our results.

Downloads

Download data is not yet available.

References

Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin 2018;68:394-424.

Siegel R, Naishadham D, Jemal A. Cancer statistics, 2013. CA Cancer J Clin 2013;63:11-30.

Parkin DM. The global burden of urinary bladder cancer. Scand J Urol Nephrol Suppl 2008;(218):12-20.

Weerawut Imsamran. Cancer in Thailand vol. IX, 2013-2015. Bangkok: Cancer Registry Unit, National Cancer Institute; 2015.

Aboumarzouk OM, Drewa T, Olejniczak P, Chlosta PL. Laparoscopic versus open radical cystectomy for muscle-invasive bladder cancer: a single institute comparative analysis. Urol Int 2013;91:109-12.

Suriyawongkul S, Gosrisirikul C, Choonhaklai V, Thaidumrong T, Pumpaisanchai S, Wongwattanasatien N, et al. Renal function of bladder cancer patients after urinary diversion by ileal conduit in Rajavithi Hospital. Insight Urol 2021;42:34-9.

Lin T, Fan X, Zhang C, Xu K, Liu H, Zhang J, et al. A prospective randomised controlled trial of laparoscopic vs open radical cystectomy for bladder cancer: perioperative and oncologic outcomes with 5-year follow-up.Br J Cancer 2014;110:842-9.

Aboumarzouk OM, Drewa T, Olejniczak P, Chlosta PL. Laparoscopic radical cystectomy: a 5-year review of a single institute’s operative data and complications and a systematic review of the literature. Int Braz J Urol 2012;38:330-40.

Kim TH, Sung HH, Jeon HG, Seo SI, Jeon SS, Lee HM, et al. Oncological Outcomes in Patients Treated with Radical Cystectomy for Bladder Cancer: Comparison Between Open, Laparoscopic, and Robot-Assisted Approaches. J endourol 2016;30:783- 91.

Guillotreau J, Gamé X, Mouzin M, Doumerc N, Mallet R, Sallusto F, et al. Radical cystectomy for bladder cancer: morbidity of laparoscopic versus open surgery. J Urol 2009;181:554-9; discussion 9.

Basillote JB, Abdelshehid C, Ahlering TE, Shanberg AM. Laparoscopic assisted radical cystectomy with ileal neobladder: a comparison with the open approach. J Urol 2004;172:489-93.

Ha US, Kim SI, Kim SJ, Cho HJ, Hong SH, Lee JY, et al. Laparoscopic versus open radical cystectomy for the management of bladder cancer: mid-term oncological outcome. Int J Urol 2010;17:55-61.

Hemal AK, Kolla SB. Comparison of laparoscopic and open radical cystoprostatectomy for localized bladder cancer with 3-year oncological followup: a single surgeon experience. J Urol 2007;178:2340-3.

Gillion N, Xylinas E, Durand X, Ploussard G, Vordos D, Allory Y, et al. Mid-term oncological control after laparoscopic radical cystectomy in men: a single-centre experience. BJU Int 2011;108:1180-4.

Snow-Lisy DC, Campbell SC, Gill IS, Hernandez AV, Fergany A, Kaouk J, et al. Robotic and laparoscopic radical cystectomy for bladder cancer: long-term oncologic outcomes. Eur Urol 2014;65:193-200.

Siriboonpipattana N, Nualyong C, Taweemonkongsap T, Leewansangtong S, Ramart P, Amornvesukit T. The Oncologic Outcome of Laparoscopic Radical Cystectomy for Invasive Bladder Cancer in Siriraj Hospital Between 2005-2013. Siriraj Med J 2017;69:377-83.

Froehner M, Brausi MA, Herr HW, Muto G, Studer UE. Complications following radical cystectomy for

bladder cancer in the elderly. Eur Urol 2009;56:443-54.

Zeng S, Zhang Z, Yu X, Song R, Wei R, Zhao J, et al. Laparoscopic versus open radical cystectomy for elderly patients over 75-year-old: a single center comparative analysis. PloS one 2014;9:e98950.

Haber GP, Crouzet S, Gill IS. Laparoscopic and robotic assisted radical cystectomy for bladder cancer: a critical analysis. Eur Urol 2008;54:54-62.

Downloads

Published

2021-11-30

How to Cite

Sirikul, T., Sriplakich, S., & Amantakul, A. (2021). Comparison of open and laparoscopic radical cystectomy as regards long-term oncological outcomes for bladder cancer. Insight Urology, 42(2), 123–130. https://doi.org/10.52786/isu.a.34

Issue

Section

Original article