title: Contemporary evidence for robot-assisted radical cystectomy for treating bladder cancer.
abstract: Robot-assisted radical cystectomy (RARC) is an evolving technique for the treatment of muscle-invasive bladder cancer (MIBC); however, its effectiveness compared with open radical cystectomy (ORC) - the established modality - is debated. Six specific areas of evidence are critically important for supporting the continuing use of RARC for MIBC, including technical aspects of surgery, perioperative outcomes, complications, oncological outcomes, functional outcomes, and financial costs. Considerable progress has been made regarding these aspects and data show that RARC replicates the technical benchmarks of ORC in terms of success of cystectomy, lymph node dissection, and urinary diversion, and could offer advantages over the more-established technique. Despite some clear benefits of RARC (such as reduced blood loss) other perioperative outcomes, including duration of inpatient stay and 30-90 day complication rates, seem to be similar to those of ORC. Current data on oncological and functional outcomes are promising, but robust data from prospective studies will help determine the indications for use of RARC for treating MIBC in the future.
authors: Division of Urology, Department of Surgery, Sunnybrook Health Sciences Centre and University of Toronto, 2075 Bayview Avenue, Toronto, Ontario M4N 3M5, Canada.|USC Institute of Urology and Norris Comprehensive Cancer Center, Keck School of Medicine of USC, University of Southern California, 1441 Eastlake Avenue, Los Angeles, California 90033, USA.
authors: Raj
authors: R
authors: Satkunasivam
authors: Division of Urology, Department of Surgery, Sunnybrook Health Sciences Centre and University of Toronto, 2075 Bayview Avenue, Toronto, Ontario M4N 3M5, Canada.
authors: Christopher J D
authors: CJ
authors: Wallis
authors: Division of Urology, Department of Surgery, Sunnybrook Health Sciences Centre and University of Toronto, 2075 Bayview Avenue, Toronto, Ontario M4N 3M5, Canada.
authors: Robert K
authors: RK
authors: Nam
authors: USC Institute of Urology and Norris Comprehensive Cancer Center, Keck School of Medicine of USC, University of Southern California, 1441 Eastlake Avenue, Los Angeles, California 90033, USA.
authors: Mihir
authors: M
authors: Desai
authors: USC Institute of Urology and Norris Comprehensive Cancer Center, Keck School of Medicine of USC, University of Southern California, 1441 Eastlake Avenue, Los Angeles, California 90033, USA.
authors: Inderbir S
authors: IS
authors: Gill
mesh_terms: D003362:Cost-Benefit Analysis; D015653:Cystectomy / Q000191:economics / Q000379:methods* / Q000639:trends; D019317:Evidence-Based Medicine / Q000191:economics / Q000379:methods* / Q000639:trends; D006801:Humans; D016032:Randomized Controlled Trials as Topic / Q000379:methods; D065287:Robotic Surgical Procedures / Q000191:economics / Q000379:methods* / Q000639:trends; D016896:Treatment Outcome; D001749:Urinary Bladder Neoplasms / Q000175:diagnosis / Q000191:economics / Q000601:surgery*