Comparison of Complication and Readmission Rates Between Robot-Assisted and Open Radical Cystectomy: Results From the...

Area of Science:

• Urology
• Surgical Oncology
• Minimally Invasive Surgery

Background:

• Radical cystectomy is a standard treatment for muscle-invasive bladder cancer.
• Robot-assisted radical cystectomy (RARC) offers potential benefits over open radical cystectomy (ORC) in recovery.
• Comparative data on complications and readmissions between RARC and ORC are crucial for clinical decision-making.

Purpose of the Study:

• To compare complication and readmission rates between RARC and ORC.
• To identify predictors of major complications and readmissions following radical cystectomy.

Main Methods:

• Utilized data from the per-protocol population of the RAZOR (Randomized Robotic-Assisted vs Open Radical Cystectomy) clinical trial.
• Comprised 150 patients in the RARC arm and 152 in the ORC arm, with a median follow-up of 2 years.
• Assessed complications using Clavien-Dindo classification and analyzed readmissions at 90 days and 1 year postoperatively.

Main Results:

• No significant differences were observed in overall or major complication rates between RARC and ORC.
• Readmission rates at 90 days (24.1% RARC vs 23.1% ORC) and 1 year (29.5% RARC vs 28.5% ORC) were similar.
• A simplified frailty index of 3 or higher significantly predicted major complications and readmissions in both groups.

Conclusions:

• RARC and ORC demonstrate comparable rates of major complications and readmissions.
• Patient frailty is a significant predictor of postoperative complications and readmissions.
• Emphasizes the importance of patient selection and preoperative optimization for radical cystectomy outcomes.