Robot-assisted radical cystectomy vs open radical cystectomy in patients with bladder cancer: a systematic review and meta-analysis of randomized controlled trials
Abstract Purpose Even though there isn't enough clinical evidence to demonstrate that robot-assisted radical cystectomy (RARC) is preferable to open radical cystectomy (ORC), RARC has become a widely used alternative. We performed the present study of RARC vs ORC with a focus on oncologic, path...
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2023-08-01
|
| Series: | World Journal of Surgical Oncology |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12957-023-03132-4 |
| _version_ | 1797559354261504000 |
|---|---|
| author | Hongquan Liu Zhongbao Zhou Huibao Yao Qiancheng Mao Yongli Chu Yuanshan Cui Jitao Wu |
| author_facet | Hongquan Liu Zhongbao Zhou Huibao Yao Qiancheng Mao Yongli Chu Yuanshan Cui Jitao Wu |
| author_sort | Hongquan Liu |
| collection | DOAJ |
| description | Abstract Purpose Even though there isn't enough clinical evidence to demonstrate that robot-assisted radical cystectomy (RARC) is preferable to open radical cystectomy (ORC), RARC has become a widely used alternative. We performed the present study of RARC vs ORC with a focus on oncologic, pathological, perioperative, and complication-related outcomes and health-related quality of life (QOL). Methods We conducted a literature review up to August 2022. The search included PubMed, EMBASE and Cochrane controlled trials register databases. We classified the studies according to version 2 of the Cochrane risk-of-bias tool for randomized trials (RoB 2). The data was assessed by Review Manager 5.4.0. Results 8 RCTs comparing 1024 patients were analyzed in our study. RARC was related to lower estimated blood loss (weighted mean difference (WMD): -328.2; 95% CI -463.49—-192.92; p < 0.00001), lower blood transfusion rates (OR: 0.45; 95% CI 0.32 – 0.65; p < 0.0001) but longer operation time (WMD: 84.21; 95% CI 46.20 -121.72; p < 0.0001). And we found no significant difference in terms of positive surgical margins (P = 0.97), lymph node yield (P = 0.30) and length of stay (P = 0.99). Moreover, no significant difference was found between the two groups in terms of survival outcomes, pathological outcomes, postoperative complication outcomes and health-related QOL. Conclusion Based on the present evidence, we demonstrated that RARC and ORC have similar cancer control results. RARC is related to less blood loss and lower transfusion rate. We found no difference in postoperative complications and health-related QOL between robotic and open approaches. RARC procedures could be used as an alternate treatment for bladder cancer patients. Additional RCTs with long-term follow-up are needed to validate this observation. |
| first_indexed | 2024-03-10T17:44:11Z |
| format | Article |
| id | doaj.art-b34d3922712347f1b4fa9ce69fca1b42 |
| institution | Directory Open Access Journal |
| issn | 1477-7819 |
| language | English |
| last_indexed | 2024-03-10T17:44:11Z |
| publishDate | 2023-08-01 |
| publisher | BMC |
| record_format | Article |
| series | World Journal of Surgical Oncology |
| spelling | doaj.art-b34d3922712347f1b4fa9ce69fca1b422023-11-20T09:36:52ZengBMCWorld Journal of Surgical Oncology1477-78192023-08-0121111610.1186/s12957-023-03132-4Robot-assisted radical cystectomy vs open radical cystectomy in patients with bladder cancer: a systematic review and meta-analysis of randomized controlled trialsHongquan Liu0Zhongbao Zhou1Huibao Yao2Qiancheng Mao3Yongli Chu4Yuanshan Cui5Jitao Wu6Department of Urology, The Affiliated Yantai Yuhuangding Hospital of Qingdao UniversityDepartment of Urology, Fengtai District, Beijing TianTan Hospital, Capital Medical University. NoDepartment of Urology, The Affiliated Yantai Yuhuangding Hospital of Qingdao UniversityDepartment of Urology, The Affiliated Yantai Yuhuangding Hospital of Qingdao UniversityDepartment of Scientific Research, The Affiliated Yantai Yuhuangding Hospital of Qingdao UniversityDepartment of Urology, The Affiliated Yantai Yuhuangding Hospital of Qingdao UniversityDepartment of Urology, The Affiliated Yantai Yuhuangding Hospital of Qingdao UniversityAbstract Purpose Even though there isn't enough clinical evidence to demonstrate that robot-assisted radical cystectomy (RARC) is preferable to open radical cystectomy (ORC), RARC has become a widely used alternative. We performed the present study of RARC vs ORC with a focus on oncologic, pathological, perioperative, and complication-related outcomes and health-related quality of life (QOL). Methods We conducted a literature review up to August 2022. The search included PubMed, EMBASE and Cochrane controlled trials register databases. We classified the studies according to version 2 of the Cochrane risk-of-bias tool for randomized trials (RoB 2). The data was assessed by Review Manager 5.4.0. Results 8 RCTs comparing 1024 patients were analyzed in our study. RARC was related to lower estimated blood loss (weighted mean difference (WMD): -328.2; 95% CI -463.49—-192.92; p < 0.00001), lower blood transfusion rates (OR: 0.45; 95% CI 0.32 – 0.65; p < 0.0001) but longer operation time (WMD: 84.21; 95% CI 46.20 -121.72; p < 0.0001). And we found no significant difference in terms of positive surgical margins (P = 0.97), lymph node yield (P = 0.30) and length of stay (P = 0.99). Moreover, no significant difference was found between the two groups in terms of survival outcomes, pathological outcomes, postoperative complication outcomes and health-related QOL. Conclusion Based on the present evidence, we demonstrated that RARC and ORC have similar cancer control results. RARC is related to less blood loss and lower transfusion rate. We found no difference in postoperative complications and health-related QOL between robotic and open approaches. RARC procedures could be used as an alternate treatment for bladder cancer patients. Additional RCTs with long-term follow-up are needed to validate this observation.https://doi.org/10.1186/s12957-023-03132-4Bladder cancerRobot-assisted radical cystectomyOpen radical cystectomyRandomized controlled trialMeta-analysis |
| spellingShingle | Hongquan Liu Zhongbao Zhou Huibao Yao Qiancheng Mao Yongli Chu Yuanshan Cui Jitao Wu Robot-assisted radical cystectomy vs open radical cystectomy in patients with bladder cancer: a systematic review and meta-analysis of randomized controlled trials World Journal of Surgical Oncology Bladder cancer Robot-assisted radical cystectomy Open radical cystectomy Randomized controlled trial Meta-analysis |
| title | Robot-assisted radical cystectomy vs open radical cystectomy in patients with bladder cancer: a systematic review and meta-analysis of randomized controlled trials |
| title_full | Robot-assisted radical cystectomy vs open radical cystectomy in patients with bladder cancer: a systematic review and meta-analysis of randomized controlled trials |
| title_fullStr | Robot-assisted radical cystectomy vs open radical cystectomy in patients with bladder cancer: a systematic review and meta-analysis of randomized controlled trials |
| title_full_unstemmed | Robot-assisted radical cystectomy vs open radical cystectomy in patients with bladder cancer: a systematic review and meta-analysis of randomized controlled trials |
| title_short | Robot-assisted radical cystectomy vs open radical cystectomy in patients with bladder cancer: a systematic review and meta-analysis of randomized controlled trials |
| title_sort | robot assisted radical cystectomy vs open radical cystectomy in patients with bladder cancer a systematic review and meta analysis of randomized controlled trials |
| topic | Bladder cancer Robot-assisted radical cystectomy Open radical cystectomy Randomized controlled trial Meta-analysis |
| url | https://doi.org/10.1186/s12957-023-03132-4 |
| work_keys_str_mv | AT hongquanliu robotassistedradicalcystectomyvsopenradicalcystectomyinpatientswithbladdercancerasystematicreviewandmetaanalysisofrandomizedcontrolledtrials AT zhongbaozhou robotassistedradicalcystectomyvsopenradicalcystectomyinpatientswithbladdercancerasystematicreviewandmetaanalysisofrandomizedcontrolledtrials AT huibaoyao robotassistedradicalcystectomyvsopenradicalcystectomyinpatientswithbladdercancerasystematicreviewandmetaanalysisofrandomizedcontrolledtrials AT qianchengmao robotassistedradicalcystectomyvsopenradicalcystectomyinpatientswithbladdercancerasystematicreviewandmetaanalysisofrandomizedcontrolledtrials AT yonglichu robotassistedradicalcystectomyvsopenradicalcystectomyinpatientswithbladdercancerasystematicreviewandmetaanalysisofrandomizedcontrolledtrials AT yuanshancui robotassistedradicalcystectomyvsopenradicalcystectomyinpatientswithbladdercancerasystematicreviewandmetaanalysisofrandomizedcontrolledtrials AT jitaowu robotassistedradicalcystectomyvsopenradicalcystectomyinpatientswithbladdercancerasystematicreviewandmetaanalysisofrandomizedcontrolledtrials |