title: Does minimally invasive surgery for radical cystectomy provide similar long-term cancer control as open radical surgery?
abstract: OBJECTIVE
  Open radical cystectomy (ORC) and pelvic lymph node dissection (PLND) is the standard treatment for muscle-invasive and high-risk nonmuscle-invasive bladder cancer (BCa), but is associated with significant morbidity. In the hope of decreasing the complications and improving the surgical tolerance, minimally invasive techniques to perform radical cystectomy and PLND have been adopted. This review focuses on the present state of the literature regarding the oncological efficacy of minimally invasive radical cystectomy (MIRC) and PLND.
  
  
  RESULTS
  Most studies are retrospective, single surgeon or institution, and are subjected to significant selection bias. There is scarce data regarding intermediate and long term oncological outcomes following MIRC, and most reported series contain a lower proportion of patients with locally advanced disease compared with ORC series. Positive surgical margin rates are similar between the approaches in localized disease, but may be significantly higher in MIRC in patients with more advanced tumors.
  
  
  CONCLUSIONS
  The current review of the literature demonstrates insufficient evidence regarding the long-term oncological outcomes of MIRC. There is a need for well controlled, prospective, randomized trials with sufficient follow-up to compare MIRC to ORC for the treatment of invasive BCa before the oncologic efficacy of these techniques can be adequately compared to the standards established by ORC.
authors.affiliation: Urology Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, New York 10021, USA.
authors.forename: Gal E
authors.initials: GE
authors.lastname: Keren Paz
authors.forename: Vincent P
authors.initials: VP
authors.lastname: Laudone
authors.forename: Bernard H
authors.initials: BH
authors.lastname: Bochner
mesh_terms: D015653:Cystectomy / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D008197:Lymph Node Excision; D019060:Minimally Invasive Surgical Procedures; D009367:Neoplasm Staging; D018579:Patient Selection; D012307:Risk Factors; D012371:Robotics; D025321:Surgery, Computer-Assisted; D016896:Treatment Outcome; D001749:Urinary Bladder Neoplasms / Q000473:pathology / Q000601:surgery*