Comparison Of Oncologic Outcomes Between Open And Laparoscopic Radical Cystectomy

Objective:To compare the long-term oncological outcomes of open radical cystectomy(ORC)and laparoscopic radical cystectomy(LRC).Methods:A retrospective analysis of 164 patients who underwent radical cystectomy in Nanchong Central Hospital from 2008 to 2018.According to gender,age,body mass index,American Society of Anesthesiologists score,tumor T,N clinical stage,neoadjuvant chemotherapy,positive tumor margins,and lymph node metastasis were matched by a 1:1 propensity score matching method to compare the prognosis differences between the ORC and the LRC before and after matching.Results:The median follow-up time of this study was 42 months.A total of 38 patients with ORC and 126 patients with LRC were included.After 1:1 propensity score matching,a total of 68 patients were successfully matched.The tumor recurrence rates in the ORC group and LRC group were 32.3%and 34.2%,respectively(P=0.843),and the median recurrence time was 12 months in both groups(P=0.703),whose difference was not statistically significant.The progression free survival(PFS)rates of the two groups were 71.1%and 66.7%,respectively(P=0.744),and the cancer-specific survival(CSS)rates were 78.9%and 82.5%,respectively(P=0.597),and the overall survival(OS)were 76.3%and 75.4%,respectively(P=0.935).Obviously,these differences were not statistically significant.Cox regression analysis showed that clinical stage T4 and lymph node metastasis were independent risk factors for prognosis.Conclusion:The long-term oncological outcomes of laparoscopic radical cystectomy were comparable to open surgery,and the clinical stage T4 and lymph node metastasis were independent risk factors for the prognosis of radical bladder cancer.