Background/Objectives: Robot-assisted radical cystectomy (RARC) has demonstrated improved perioperative outcomes and recovery in bladder cancer (BCa) patients. This study compares patient and tumor characteristics, operative time (OT), length of stay (LOS), and complication rates between a historical (2003–2016) and a contemporary cohort (2017–2024) treated at a high-volume robotic center. Methods: Data from 274 BCa patients who underwent RARC at AZORG Hospital, Aalst, Belgium, were analyzed. Perioperative outcomes were compared between cohorts. Multivariable Poisson regression models identified predictors of longer OT and LOS, while multivariable logistic regression models (MLRMs) assessed predictors of higher complication rates. Results: Overall, 274 BCa patients who underwent RARC were identified (38% historical cohort vs. 62% contemporary cohort). The contemporary cohort had a significantly shorter median OT (345 vs. 360 min;p= 0.048) and LOS (8 vs. 12 days;p< 0.001) compared to the historical cohort. Postoperative complications were lower in the contemporary group, with more cases experiencing no complications (60% vs. 41%) and fewer grade 3–4 complications (10% vs. 27%;p< 0.001). In multivariable Poisson regression, the contemporary cohort was an independent predictor of shorter OT (Incidence Rate Ratio [IRR]: 0.94, 95% [Confidence Interval] CI: 0.93–0.96;p= 0.04) and shorter LOS (IRR: 0.65, 95% CI: 0.60–0.69;p< 0.001). In MLRMs predicting complications, the contemporary cohort was associated with lower risk (Odds Ratio: 0.42, 95% CI: 0.23–0.76;p= 0.005). Conclusions: RARC outcomes improved significantly over time, with reduced OT, LOS, and complication rates in the contemporary cohort, highlighting advancements in surgical techniques, perioperative care, and patient safety. These findings reinforce the role of RARC in optimizing BCa treatment.
背景/目的：机器人辅助根治性膀胱切除术（RARC）已被证实可改善膀胱癌（BCa）患者的围手术期结局及恢复情况。本研究比较了在一家高手术量机器人中心接受治疗的历史队列（2003–2016年）与当代队列（2017–2024年）的患者及肿瘤特征、手术时间（OT）、住院时间（LOS）以及并发症发生率。方法：分析了比利时阿尔斯特市AZORG医院接受RARC的274例BCa患者的数据，比较了两组间的围手术期结局。采用多变量泊松回归模型识别较长OT和LOS的预测因素，同时使用多变量逻辑回归模型（MLRMs）评估较高并发症发生率的预测因素。结果：共纳入274例接受RARC的BCa患者（历史队列占38%，当代队列占62%）。与历史队列相比，当代队列的中位OT（345分钟 vs. 360分钟；p=0.048）和LOS（8天 vs. 12天；p<0.001）均显著缩短。当代队列的术后并发症发生率更低，无并发症病例更多（60% vs. 41%），且3–4级并发症更少（10% vs. 27%；p<0.001）。在多变量泊松回归中，当代队列是较短OT（发生率比[IRR]：0.94，95%置信区间[CI]：0.93–0.96；p=0.04）和较短LOS（IRR：0.65，95% CI：0.60–0.69；p<0.001）的独立预测因素。在预测并发症的MLRMs中，当代队列与较低风险相关（比值比：0.42，95% CI：0.23–0.76；p=0.005）。结论：RARC的结局随时间显著改善，当代队列的OT、LOS和并发症发生率均降低，突显了手术技术、围手术期护理和患者安全方面的进步。这些发现进一步证实了RARC在优化BCa治疗中的作用。
肿瘤(癌症)患者之家