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Long-term oncologic and functional outcomes following robot-assisted radical cystectomy and intracorporeal Padua ileal bladder: results from a single high-volume center

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World Journal of Urology Aims and scope Submit manuscript

A Letter to the Editor to this article was published on 16 September 2023

Abstract

Purpose

To report long-term oncologic and functional outcomes of a large consecutive single center series of Robot-assisted radical cystectomy (RARC)- intracorporeal (IC) Urinary Diversion (UD), identifying their predicting factors.

Methods

A single center Bladder cancer (BC) database was queried for “RARC” and “ICUD”, including patients treated between January 2012 and September 2020. Kaplan–Meier curves were assessed disease-free (DFS), cancer-specific (CSS) and overall survival (OS) probability. Univariable (UV) and multivariable (MV) analysis were adopted to identify predictors of DFS, CSS and OS. Kaplan–Meier method evaluated day- and night-time continence recovery probabilities; UV and MV analysis were adopted to identify predictors of Day-time continence.

Results

Overall, 251 patients were included. Among them, 192 patients underwent intracorporeal ileal orthotopic neobladder (ION) (76.5%). Five-year DFS, CSS and OS rates were 66.5%, 65.4% and 61.5%; pT stage ≥ 3 and pathologic nodal involvement were identified as negative independent predictors of DFS (HR 2.39, p = 0.001, HR 4.64, p ≤  0.001), CSS (HR 2.20, p = 0.01, HR 3.97, p < 0.001) and OS (HR 2.25, p = 0.005, HR 3.95, p < 0.001). In RARC-ION patients, Trifecta rate was 64.1%. One-year day- and night-time continence rates were 78.6% and 48.3%. Age (HR 0.98, p = 0.03), female gender (HR 0.57, p = 0.008) and complications Clavien grade ≥ 3 (HR 0.55, p = 0.03) were identified as independent predictors of day-time incontinence.

Conclusions

Long-term oncologic outcomes and their predicting factors seem aligned to the largest historical open series and multi-institutional robotic series data. According to the identified predicting factors undermining a proper achievement of day-time continence, this represents an objective support, in order to properly advice specific sub-group of patients.

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Funding

The authors did not receive support from any organization for the submitted work. -The authors have no relevant financial or non-financial interests to disclose.

Author information

Authors and Affiliations

  1. Department of Urology, IRCCS “Regina Elena” National Cancer Institute, Via Elio, Chianesi 53, Rome, Italy

    Gabriele Tuderti, Riccardo Mastroianni, Giuseppe Chiacchio, Umberto Anceschi, Alfredo Maria Bove, Aldo Brassetti, Mariaconsiglia Ferriero, Leonardo Misuraca, Rocco Simone Flammia, Flavia Proietti, Simone D’Annunzio, Costantino Leonardo, Salvatore Guaglianone, Marianna Anselmi, Ashanti Zampa, Giulia Torregiani, Michele Gallucci & Giuseppe Simone

  2. Urology Unit, Azienda Ospedaliero-Universitaria Ospedali Riuniti di Ancona, Università Politecnica delle Marche, Ancona, Italy

    Giuseppe Chiacchio & Andrea Benedetto Galosi

  3. Department of Urology, “Sapienza” University of Rome, Rome, Italy

    Rocco Simone Flammia

Authors
  1. Gabriele Tuderti
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  2. Riccardo Mastroianni
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  7. Mariaconsiglia Ferriero
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  8. Leonardo Misuraca
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  18. Michele Gallucci
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  19. Giuseppe Simone
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Contributions

TG contributed to project development, data analysis, manuscript writing. MR contributed to data collection. CG contributed to data collection. AU contributed to data collection. Bove AM contributed to data collection. BA contributed to data collection. FM contributed to data collection. ML: contributed to data collection. FRS contributed to data collection. PF contributed to data collection. D’AS contributed to data collection. Leonardo C contributed to data collection. GS contributed to data collection. AM contributed to data collection. ZA contributed to data collection. GAB contributed to data collection. TG contributed to data collection. GM contributed to manuscript editing, supervision. SG contributed to project development, data analysis, manuscript editing, supervision.

Corresponding author

Correspondence to Gabriele Tuderti.

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Tuderti, G., Mastroianni, R., Chiacchio, G. et al. Long-term oncologic and functional outcomes following robot-assisted radical cystectomy and intracorporeal Padua ileal bladder: results from a single high-volume center. World J Urol 41, 2359–2366 (2023). https://doi.org/10.1007/s00345-023-04523-8

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