Department of Urology, Gifu University Graduate School of Medicine, Gifu, Japan.
Department of Urology, Kizawa Memorial Hospital, Minokamo, Japan.
Urol Int. 2020;104(7-8):573-579. doi: 10.1159/000508192. Epub 2020 Jun 17.
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).
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.
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.
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.
本研究旨在比较腹腔镜根治性膀胱切除术（LRC）与开放性根治性膀胱切除术（ORC）治疗肌层浸润性膀胱癌（MIBC）患者的手术和肿瘤学结果及并发症。
我们的研究集中在经组织学证实的无远处转移的 T2-T4a 期膀胱尿路上皮癌患者，他们接受了 LRC（LRC 组）或 ORC（ORC 组）。本研究的主要终点是总生存率（OS）和无复发生存率（RFS）。
本研究共纳入 59 例患者，其中 17 例接受 LRC，42 例接受 ORC。LRC 组的 2 年 OS 率为 100%，ORC 组为 88.0%（p=0.85）。LRC 组的 2 年 RFS 率为 63.5%，ORC 组为 69.5%（p=0.321）。多因素分析显示，组织学类型、阳性淋巴结和阳性切缘与 OS 率显著相关。
本研究表明，LRC 可能与 ORC 相比具有相似的肿瘤学结果、更少的围手术期并发症和更少的失血。因此，LRC 应被视为 MIBC 患者的治疗选择之一。
