Background: The aim of this study was to compare the surgical and oncological outcomes and complications of laparoscopic radical cystectomy (LRC) to those of open radical cystectomy (ORC) in patients with muscle-invasive bladder cancer (MIBC). Methods: Our study focused on patients with histologically confirmed stage T2–T4a urothelial carcinoma of the bladder without distant metastases, who underwent LRC (LRC group) or ORC (ORC group). The primary endpoints in this study were the overall survival (OS) and recurrence-free survival (RFS) rates. Results: In this study, 59 patients, 17 underwent LRC and 42 underwent ORC, were enrolled. The 2-year OS rate was 100% in the LRC group and 88.0% in the ORC group (p = 0.85). The 2-year RFS rate was 63.5% in the LRC group and 69.5% in the ORC group (p = 0.321). On multivariate analysis, the histological type, positive lymph node, and positive resection margin were significantly associated with the OS rates. Conclusions: This study suggested that LRC may achieve similar oncological outcomes and fewer perioperative complications and less blood loss compared to ORC. Therefore, LRC should be considered as one of the treatment options for patients with MIBC.

1.
Hautmann
RE
,
de Petriconi
RC
,
Pfeiffer
C
,
Volkmer
BG
.
Radical cystectomy for urothelial carcinoma of the bladder without neoadjuvant or adjuvant therapy: long-term results in 1100 patients
.
Eur Urol
.
2012 May
;
61
(
5
):
1039
47
.
2.
Gore
JL
,
Litwin
MS
,
Lai
J
,
Yano
EM
,
Madison
R
,
Setodji
C
, et al.
Use of radical cystectomy for patients with invasive bladder cancer
.
J Natl Cancer Inst
.
2010 Jun
;
102
(
11
):
802
11
.
3.
Zakaria
AS
,
Santos
F
,
Dragomir
A
,
Tanguay
S
,
Kassouf
W
,
Aprikian
AG
.
Postoperative mortality and complications after radical cystectomy for bladder cancer in Quebec: a population-based analysis during the years 2000–2009
.
Can Urol Assoc J
.
2014 Jul
;
8
(
7–8
):
259
67
.
4.
Ito
K
,
Kanno
T
,
Sawada
A
,
Saito
R
,
Kobayashi
T
,
Yamada
H
, et al.
Laparoscopic radical cystectomy in octogenarians: analysis of a Japanese multicenter cohort
.
Int J Clin Oncol
.
2019 Sep
;
24
(
9
):
1081
8
.
5.
Kanno
T
,
Ito
K
,
Sawada
A
,
Saito
R
,
Kobayashi
T
,
Yamada
H
, et al.
Complications and reoperations after laparoscopic radical cystectomy in a Japanese multicenter cohort
.
Int J Urol
.
2019 Apr
;
26
(
4
):
493
8
.
6.
Koie
T
,
Ohyama
C
,
Yoneyama
T
,
Nagasaka
H
,
Yamamoto
H
,
Imai
A
, et al.
Robotic cross-folded U-configuration intracorporeal ileal neobladder for muscle-invasive bladder cancer: initial experience and functional outcomes
.
Int J Med Robot
.
2018 Dec
;
14
(
6
):
e1955
.
7.
Koie
T
,
Ohyama
C
,
Yamamoto
H
,
Imai
A
,
Hatakeyama
S
,
Yoneyama
T
, et al.
The feasibility and effectiveness of robot-assisted radical cystectomy after neoadjuvant chemotherapy in patients with muscle-invasive bladder cancer
.
Jpn J Clin Oncol
.
2017 Mar
;
47
(
3
):
252
6
.
8.
Gakis
G
,
Efstathiou
J
,
Lerner
SP
,
Cookson
MS
,
Keegan
KA
,
Guru
KA
, et al.
ICUD-EAU International Consultation on Bladder Cancer 2012: radical cystectomy and bladder preservation for muscle-invasive urothelial carcinoma of the bladder
.
Eur Urol
.
2013 Jan
;
63
(
1
):
45
57
.
9.
Simonato
A
,
Gregori
A
,
Lissiani
A
,
Bozzola
A
,
Galli
S
,
Gaboardi
F
.
Laparoscopic radical cystoprostatectomy: our experience in a consecutive series of 10 patients with a 3 years follow-up
.
Eur Urol
.
2005 Jun
;
47
(
6
):
785
2
.
10.
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 Jan
;
65
(
1
):
193
200
.
11.
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 Jun 5
;
9
(
6
):
e98950
.
12.
Challacombe
BJ
,
Bochner
BH
,
Dasgupta
P
,
Gill
I
,
Guru
K
,
Herr
H
, et al.
The role of laparoscopic and robotic cystectomy in the management of muscle-invasive bladder cancer with special emphasis on cancer control and complications
.
Eur Urol
.
2011 Oct
;
60
(
4
):
767
75
.
13.
Calvert
AH
,
Newell
DR
,
Gumbrell
LA
,
O'Reilly
S
,
Burnell
M
,
Boxall
FE
, et al.
Carboplatin dosage: prospective evaluation of a simple formula based on renal function
.
J Clin Oncol
.
1989 Nov
;
7
(
11
):
1748
56
.
14.
Galsky
MD
,
Hahn
NM
,
Rosenberg
J
,
Sonpavde
G
,
Hutson
T
,
Oh
WK
, et al.
Treatment of patients with metastatic urothelial cancer “unfit” for Cisplatin-based chemotherapy
.
J Clin Oncol
.
2011 Jun 10
;
29
(
17
):
2432
8
.
15.
Stein
JP
,
Skinner
DG
.
Surgical atlas. Radical cystectomy
.
BJU Int
.
2004 Jul
;
94
(
1
):
197
221
.
16.
Bricker
EM
.
Bladder substitution after pelvic evisceration
.
J Urol
.
1950 Oct
;
167
(
2 Pt 2
):
1140
6
.
17.
Dwoskin
JY
.
Loop cutaneous ureterostomy and cutaneous pyelostomy: one-stage reconstruction
.
J Urol
.
1998
;
112
(
2
):
275
9
.
18.
American Joint Committee on Cancer
.
Urinary bladder
. In:
Edge
SB
,
Byrd
DR
,
Compton
CC
,
Fritz
AG
,
Greene
F
,
Trotti
A
, editors.
AJCC cancer staging manual
. 7th ed.
New York
:
Springer
;
2010
. p.
497
505
.
19.
Clavien
PA
,
Barkun
J
,
de Oliveira
ML
,
Vauthey
JN
,
Dindo
D
,
Schulick
RD
, et al.
The Clavien-Dindo classification of surgical complications: five-year experience
.
Ann Surg
.
2009 Aug
;
250
(
2
):
187
96
.
20.
Tang
K
,
Li
H
,
Xia
D
,
Hu
Z
,
Zhuang
Q
,
Liu
J
, et al.
Laparoscopic versus open radical cystectomy in bladder cancer: a systematic review and meta-analysis of comparative studies
.
PLoS One
.
2014 May 16
;
9
(
5
):
e95667
.
21.
Albisinni
S
,
Oderda
M
,
Fossion
L
,
Varca
V
,
Rassweiler
J
,
Cathelineau
X
, et al.
The morbidity of laparoscopic radical cystectomy: analysis of postoperative complications in a multicenter cohort by the European Association of Urology (EAU)-Section of Uro-Technology
.
World J Urol
.
2016 Feb
;
34
(
2
):
149
56
.
22.
Dotan
ZA
,
Kavanagh
K
,
Yossepowitch
O
,
Kaag
M
,
Olgac
S
,
Donat
M
, et al.
Positive surgical margins in soft tissue following radical cystectomy for bladder cancer and cancer specific survival
.
J Urol
.
2007 Dec
;
178
(
6
):
2308
13
.
23.
Haber
GP
,
Crouzet
S
,
Gill
IS
.
Laparoscopic and robotic assisted radical cystectomy for bladder cancer: a critical analysis
.
Eur Urol
.
2008 Jul
;
54
(
1
):
54
62
.
24.
Koie
T
,
Ohyama
C
,
Yamamoto
H
,
Imai
A
,
Hatakeyama
S
,
Yoneyama
T
, et al.
Neoadjuvant gemcitabine and carboplatin followed by immediate cystectomy may be associated with a survival benefit in patients with clinical T2 bladder cancer
.
Med Oncol
.
2014 May
;
31
(
5
):
949
.
25.
Murasawa
H
,
Koie
T
,
Ohyama
C
,
Yamamoto
H
,
Imai
A
,
Hatakeyama
S
, et al.
The utility of neoadjuvant gemcitabine plus carboplatin followed by immediate radical cystectomy in patients with muscle-invasive bladder cancer who are ineligible for cisplatin-based chemotherapy
.
Int J Clin Oncol
.
2017 Feb
;
22
(
1
):
159
65
.
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