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KMID : 1011820220630010053
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Investigative and Clinical Urology
2022 Volume.63 No. 1 p.53 ~ p.62
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Gender-related outcomes in robot-assisted radical cystectomy: A multi-institutional study
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Jin Hyun-Jung
Shim Ji-Sung
Kwon Tae-Gyun
Kim Tae-Hwan
Jeon Seung-Hyun
Lee Sang-Hyub
Kang Sung-Gu
Nam Jong-Kil
Kim Wan-Suk
Jeong Byung-Chang
Oh Jong-Jin
Lee Sang-Chul
Lee Ji-Youl
Hong Sung-Hoo
Rha Koon-Ho
Han Woong-Kyu
Ham Won-Sik
Lee Young-Goo
Lee Yong-Seong
Park Sung-Yul
Yoon Young-Eun
Ku Ja-Hyeon
Kang Seok-Ho
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Abstract
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Purpose: Robot-assisted radical cystectomy (RARC) optimizes patient recovery and has outcomes comparable with those of open surgery. This study aimed to compare the perioperative and oncologic outcomes of RARC in female and male patients.
Materials and Methods: A retrospective cohort study of the Korean Robot-Assisted Radical Cystectomy Study Group database from 2007 to 2019 identified 749 patients (111 females and 638 males). Female were matched 1:1 to male by propensity score matching using a logistic regression. We compared perioperative outcomes, oncologic outcomes, and complications between the two groups.
Results: The female group had comparable perioperative outcomes to the male group in terms of operation time, lymph node yield, positive surgical margin, blood transfusion rate, and hospitalization days. Complication rate and grade were not significantly different between the two groups. The most common complication was infection in female and gastrointestinal complications in male. We compared the 5-year overall, disease-specific, and recurrence-free survival of female and male: 58.2% vs. 68.0% (p=0.495), 75.7% vs. 79.3% (p=0.645), and 40.8% vs. 53.5% (p=0.913), respectively. On multivariable analysis, T stage (>T2), postoperative complications, and positive surgical margin were prognostic factors of poor outcome. Sex was not an independent predictor of the three survivals.
Conclusions: The current study suggests that RARC in female has comparable perioperative and oncologic outcomes to those in male. The complication rate of RARC in female was comparable to that in male, but the type of complications differed by sex.
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KEYWORD
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Cystectomy, Female, Robotic surgical procedures, Treatment outcome, Urinary bladder neoplasms
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