Nav: Home

Robotic surgery as effective as open surgery for bladder cancer

July 11, 2018

MAYWOOD, IL - Robotic surgery is as effective as traditional open surgery in treating bladder cancer, according to a landmark study published in the journal Lancet.

Three Loyola Medicine urologists, Marcus Quek, MD, Gopal Gupta, MD, and Alex Gorbonos, MD, are co-authors of the study. First author is Dipen Parekh, MD, of the University of Miami.

Loyola is among 15 centers that participated in the nationwide trial of 350 patients, who were randomly assigned to undergo robotic surgery or open surgery to remove cancerous bladders.

After two years, there was no significant difference between the two groups in survival without disease progression. Robotic surgery was associated with less blood loss and shorter hospital stays, but longer surgeries. There were no significant differences in complication rates or in patients' quality of life. The study is called RAZOR (randomized open versus robotic cystectomy trial) and was funded by the National Cancer Institute.

A robotic system allows a surgeon to perform operations through a few small incisions. Movements by the surgeon's hand or wrist are translated into highly precise movements of the surgical instruments. Every maneuver is directed by the surgeon, in real time, as the surgeon views a magnified, 3D, high-definition image of the surgical site.

Since robotic surgery was introduced in 2000, it has spread rapidly and has been used in about four million surgeries worldwide. But apart from the RAZOR trial, there have been no prospective, randomized multicenter trials to assess how robotic surgery compares to open surgery in cancer survival.

The RAZOR trial found that two years after surgery, 72.3 percent of patients in the robotic surgery group were alive, with no disease progression and essentially cured, compared with 71.6 percent in the open surgery group. Sixty-seven percent of robotic surgery patients experienced adverse effects such as urinary tract infections and intestinal obstructions, compared with 69 percent in the open surgery group.

Robotic surgery patients stayed a median of six days in the hospital, compared with seven days in the open surgery group. Robotic surgery patients lost less than half as much blood as open surgery patients, but spent more time in the operating room (seven hours, eight minutes compared with six hours, one minute).

Researchers wrote that the findings "underscore the need for further high-quality trials to assess surgical innovation before this surgical technique is widely adopted in clinical practice."

Dr. Gupta added that the study provides evidence demonstrating that the robotic approach performs at least as well as the open approach. "It is important to conduct these trials before widespread adoption of technology, as has been the case with robotic prostatectomy (removal of the prostate)," he said.
-end-
The study is titled "Robot-assisted radical cystectomy versus open radical cystectomy in patients with bladder cancer (RAZOR): an open-label, randomized, phase 3, non-inferiority trial."

Bladder cancer is the fourth most common cancer in men, but it is less common in women. The American Cancer Society estimates this year there will be about 81,000 new cases in the United States, and about 17,000 people will die of the disease.

The standard surgical treatment of invasive bladder cancer is a radical cystectomy (removal of the bladder). Three main techniques are used to replace the bladder: construct a new bladder (neobladder) from the patient's intestine; place a pouch inside the body to act as an artificial bladder; or place a bag outside the body to collect urine. Loyola Medicine offers both open and robotic radical cystectomy and all three bladder replacement techniques. There are pros and cons to each surgical technique, and Loyola physicians help patients decide which option best fits their lifestyle and health status.

Loyola Medicine is nationally recognized for its expertise in diagnosing and treating a broad range of urologic conditions and providing integrated services for optimal patient care. Loyola's department of urology is ranked 39th in the country by U.S. News and World Report.

Loyola University Health System

Related Urinary Tract Infections Articles:

Better tests needed for urinary tract infections
Doctors urgently need a fast and accurate test for diagnosing urinary tract infections (UTIs) to reduce overprescribing of antibiotics, according to health researchers.
Urinary tract and other infections may trigger different kinds of stroke
Several infections have been identified as possible stroke triggers, with urinary tract infections showing the strongest link with ischemic stroke.
More monitoring needed to reduce post-hospitalization urinary tract infections
Broader monitoring of patients is needed to reduce the number of people who develop a urinary tract infection after being discharged from the hospital, new research suggests.
Study details bacteria's role in recurrent urinary tract infections
A new finding by researchers at The University of Texas at Dallas and UT Southwestern Medical Center shows that several species of bacteria reside in bladder tissue of postmenopausal women who experience recurrent urinary tract infections (RUTIs).
Study sheds new light on urinary tract infections in postmenopausal women
A UT Southwestern study suggests why urinary tract infections (UTIs) have such a high recurrence rate in postmenopausal women -- several species of bacteria can invade the bladder walls.
New AI can detect urinary tract infections
New AI developed at the University of Surrey could identify and help reduce one of the top causes of hospitalisation for people living with dementia: urinary tract infections (UTI).
Antibiotic resistance increases relapse in urinary tract infections
Patients with a certain drug-resistant urinary tract infection were more likely to have a relapse of their infection within a week than those with non-resistant infections and were more likely to be prescribed an incorrect antibiotic according to a study published today in Infection Control & Hospital Epidemiology, the journal of the Society for Healthcare Epidemiology of America.
More than just anatomy: sex differences in the lower urinary tract
The biological differences between women and men go beyond basic anatomy.
Women who drank more water had less frequent urinary tract infections
Premenopausal women with recurrent urinary tract infections (cystitis) who drank more water had less frequent infections in a randomized clinical trial.
E. coli strain from retail poultry may cause urinary tract infections in people
A strain of Escherichia coli (E. coli) found in retail chicken and turkey products may cause a wide range of infections in people, according to a study published today in the American Society for Microbiology's open access journal mBio.
More Urinary Tract Infections News and Urinary Tract Infections Current Events

Top Science Podcasts

We have hand picked the top science podcasts of 2019.
Now Playing: TED Radio Hour

Accessing Better Health
Essential health care is a right, not a privilege ... or is it? This hour, TED speakers explore how we can give everyone access to a healthier way of life, despite who you are or where you live. Guests include physician Raj Panjabi, former NYC health commissioner Mary Bassett, researcher Michael Hendryx, and neuroscientist Rachel Wurzman.
Now Playing: Science for the People

#543 Give a Nerd a Gift
Yup, you guessed it... it's Science for the People's annual holiday episode that helps you figure out what sciency books and gifts to get that special nerd on your list. Or maybe you're looking to build up your reading list for the holiday break and a geeky Christmas sweater to wear to an upcoming party. Returning are pop-science power-readers John Dupuis and Joanne Manaster to dish on the best science books they read this past year. And Rachelle Saunders and Bethany Brookshire squee in delight over some truly delightful science-themed non-book objects for those whose bookshelves are already full. Since...
Now Playing: Radiolab

An Announcement from Radiolab