Investig Clin Urol.
2022 Jan;63(1):53-62. 10.4111/icu.20210334.
Gender-related outcomes in robot-assisted radical cystectomy: A multi-institutional study
- Jin HJ1
- Shim JS1
- Kwon TG2
- Kim TH2
- Jeon SH3
- Lee SH3
- Kang SG1
- Nam JK4
- Kim WS5
- Jeong BC6
- Oh JJ7
- Lee SC7
- Lee JY8
- Hong SH8
- Rha KH9
- Han WK9
- Ham WS9
- Lee YG10
- Lee YS10
- Park SY11
- Yoon YE11
- Ku JH
7 - Kang SH1
- Affiliations
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- 1Department of Urology, Korea University College of Medicine, Seoul, Korea
- 2Department of Urology, Kyungpook National University School of Medicine, Daegu, Korea
- 3Department of Urology, KyungHee University College of Medicine, Seoul, Korea
- 4Department of Urology, Busan National University Yangsan Hospital, Yangsan, Korea
- 5Department of Urology, Inje University Busan Paik Hospital, Busan, Korea
- 6Department of Urology, Sungkyunkwan University School of Medicine, Seoul, Korea
- 7Department of Urology, Seoul National University College of Medicine, Seoul, Korea
- 8Department of Urology, College of Medicine, The Catholic University of Korea, Seoul, Korea
- 9Department of Urology, Yonsei University College of Medicine, Seoul, Korea
- 10Department of Urology, Hallym University School of Medicine, Seoul, Korea
- 11Department of Urology, Hanyang University College of Medicine, Seoul, Korea
- KMID: 2524276
- DOI: http://doi.org/10.4111/icu.20210334
Abstract
- 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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