Background: This study aimed to evaluate the surgical and oncological outcomes of robot-assisted radical cystectomy (RARC) versus open radical cystectomy (ORC) using trifecta and pentafecta parameters. Methods: The clinical data of 41 patients who underwent RARC between 2018 and 2022 were prospectively collected and retrospectively compared to those of 330 patients undergoing ORC using 1:1 propensity score matching. Trifecta was defined as simultaneous negative surgical margins (SMs), a lymph node (LN) yield ≥ 16, and the absence of major complications (Clavien–Dindo grade III–V) within 90 days postoperatively. Pentafecta additionally included a 12-month recurrence-free rate and a time between the transurethral resection of a bladder tumor (TURBT) and radical cystectomy (RC) ≤ 3 months. The continuous variables were compared using the Mann–Whitney U test, and the categorical variables were analyzed using the chi-squared test. Results: No statistically significant differences in trifecta and pentafecta success rates were observed between the RARC and ORC cohorts after propensity score matching. However, the RARC group exhibited significantly reduced blood loss (RARC: 317 mL vs. ORC: 525 mL,p= 0.01). Conclusions: RARC offers distinct advantages over ORC in terms of reduced blood loss, while trifecta and pentafecta success rates do not differ significantly between the two surgical approaches.
背景：本研究旨在通过三要素与五要素标准，评估机器人辅助根治性膀胱切除术（RARC）与开放根治性膀胱切除术（ORC）的手术及肿瘤学结局。方法：前瞻性收集2018年至2022年间接受RARC的41例患者的临床资料，并通过1:1倾向评分匹配与330例接受ORC的患者进行回顾性比较。三要素标准定义为同时满足手术切缘阴性、淋巴结检出数≥16枚、术后90天内无严重并发症（Clavien–Dindo分级III–V级）。五要素标准在此基础上增加12个月无复发生存率及经尿道膀胱肿瘤切除术（TURBT）至根治性膀胱切除术（RC）间隔时间≤3个月。连续变量采用Mann–Whitney U检验进行比较，分类变量采用卡方检验进行分析。结果：倾向评分匹配后，RARC组与ORC组在三要素与五要素达标率方面均无统计学显著差异。但RARC组术中失血量显著减少（RARC：317 mL vs. ORC：525 mL，p=0.01）。结论：RARC在减少术中失血量方面较ORC具有明显优势，而两种手术方式在三要素与五要素达标率上无显著差异。
肿瘤(癌症)患者之家