Oncological and functional outcomes after robot-assisted radical cystectomy: critical review of current status

Although open radical cystectomy (ORC) remains the gold-standard management of muscle-invasive bladder cancer, the number of centers performing robotic-assisted radical cystectomy (RARC) has recently increased, prompting greater oncological outcome concerns. Although limited in patient number and follow-up, short-term RARC data from centers of excellence appear to show the approach to be safe and effective, with improved perioperative and functional outcomes, while maintaining comparable oncologic efficiency. Nevertheless, despite the surge of centers adopting RARC, the long-term effectiveness of minimally-invasive techniques has yet to be proven. This review of published RARC series affirms the need for prospective, long-term, controlled studies to adequately evaluate the role of robotics in bladder cancer surgery.