Robot-assisted versus laparoscopic nephroureterectomy for upper-tract urothelial cancer: A population-based assessment of costs and perioperative outcomes

doi:10.5489/cuaj.2051

. 2014 Sep;8(9-10):E695-701.

doi: 10.5489/cuaj.2051.

Robot-assisted versus laparoscopic nephroureterectomy for upper-tract urothelial cancer: A population-based assessment of costs and perioperative outcomes

Affiliations

¹ Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Centre, Montreal, QC;
² Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Centre, Montreal, QC; ; Department of Urology, Vita-Salute, San Raffaele University Milan, Italy;
³ Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Centre, Montreal, QC; ; Martini-Clinic, Prostate Cancer Center Hamburg-Eppendorf, Hamburg, Germany;
⁴ Department of Urology, Medical University of Vienna, Vienna, Austria;
⁵ Department of Urology, Vita-Salute, San Raffaele University Milan, Italy;
⁶ Department of Urology, University of Montreal Health Centre, Montreal, QC;
⁷ Department of Surgery, Division of Urology, Brigham and Women's Hospital/Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA.
⁸ Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Centre, Montreal, QC; ; Department of Urology, University of Montreal Health Centre, Montreal, QC;

PMID: 25408809
PMCID: PMC4216301
DOI: 10.5489/cuaj.2051

Robot-assisted versus laparoscopic nephroureterectomy for upper-tract urothelial cancer: A population-based assessment of costs and perioperative outcomes

Vincent Trudeau et al. Can Urol Assoc J. 2014 Sep.

. 2014 Sep;8(9-10):E695-701.

doi: 10.5489/cuaj.2051.

Authors

Affiliations

¹ Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Centre, Montreal, QC;
² Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Centre, Montreal, QC; ; Department of Urology, Vita-Salute, San Raffaele University Milan, Italy;
³ Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Centre, Montreal, QC; ; Martini-Clinic, Prostate Cancer Center Hamburg-Eppendorf, Hamburg, Germany;
⁴ Department of Urology, Medical University of Vienna, Vienna, Austria;
⁵ Department of Urology, Vita-Salute, San Raffaele University Milan, Italy;
⁶ Department of Urology, University of Montreal Health Centre, Montreal, QC;
⁷ Department of Surgery, Division of Urology, Brigham and Women's Hospital/Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA.
⁸ Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Centre, Montreal, QC; ; Department of Urology, University of Montreal Health Centre, Montreal, QC;

PMID: 25408809
PMCID: PMC4216301
DOI: 10.5489/cuaj.2051

Abstract

Introduction: We compared short-term outcomes and costs between robotic-assisted nephroureterectomy (RANU) and laparoscopic radical nephroureterectomy (LNU) in a large population-based cohort of patients with upper-tract urothelial carcinoma (UTUC).

Methods: Overall, 1914 patients with UTUC treated with RANU or LNU between 2008 and 2010 within the Nationwide Inpatient Sample were abstracted. Propensity-score matching was performed to account for inherent differences between patients undergoing RANU and LNU. Multivariable logistic regression models were fitted to compare postoperative complications, blood transfusions, prolonged length of stay, and costs between the 2 procedures.

Results: Overall, a weighted estimate of 1199 (62.6%) and 715 (37.4%) patients received LNU and RANU, respectively. In multivariable analyses no significant differences were observed in postoperative transfusion and length of stay between the 2 surgical approaches (all p > 0.1). However, patients undergoing RANU were less likely to experience any complications compared to their counterparts undergoing LNU (p = 0.04). The utilization of RANU was associated with substantially higher costs compared to the laparoscopic approach. Our study is limited by its retrospective nature and the lack of adjustment for tumour stage and grade.

Conclusions: Our results support the safety and feasibility of RANU for the treatment of UTUC. Indeed, the use of the robotic approach was associated with lower probability of experiencing perioperative complications compared to LNU. On the other hand, the utilization of RANU is associated with higher costs compared to LNU.

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Figures

**Fig. 1.**
Use of laparoscopic radical nephroureterectomy (LNU) and robot-assisted radical nephroureterectomy (RANU) in patients with upper tract urothelial carcinoma (UTUC) included within the Nationwide Inpatient Sample (NIS) database between October 2008 and December 2010.

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References

1. Siegel R, Naishadham D, Jemal A. Cancer statistics, 2013. CA Cancer J Clin. 2013;63:11–30. doi: 10.3322/caac.21166. - DOI - PubMed
1. Rouprêt M, Babjuk M, Compérat E, et al. European Guidelines on Upper Tract Urothelial Carcinomas: 2013 Update. Eur Urol. 2013;63:1059–71. doi: 10.1016/j.eururo.2013.03.032. - DOI - PubMed
1. Hanna N, Sun M, Trinh QD, et al. Propensity-score-matched comparison of perioperative outcomes between open and laparoscopic nephroureterectomy: A national series. Eur Urol. 2012;61:715–21. doi: 10.1016/j.eururo.2011.12.026. - DOI - PubMed
1. Yu H-Y, Hevelone ND, Lipsitz SR, et al. Use, costs and comparative effectiveness of robotic assisted, laparoscopic and open urological surgery. J Urol. 2012;187:1392–9. doi: 10.1016/j.juro.2011.11.089. - DOI - PubMed
1. Merseburger AS, Herrmann TR, Shariat SF, et al. EAU Guidelines on Robotic and Single-site Surgery in Urology. Eur Urol. 2013;64:277–91. doi: 10.1016/j.eururo.2013.05.034. - DOI - PubMed

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[1] Siegel R, Naishadham D, Jemal A. Cancer statistics, 2013. CA Cancer J Clin. 2013;63:11–30. doi: 10.3322/caac.21166. - DOI - PubMed

[2] Siegel R, Naishadham D, Jemal A. Cancer statistics, 2013. CA Cancer J Clin. 2013;63:11–30. doi: 10.3322/caac.21166. - DOI - PubMed

[3] Rouprêt M, Babjuk M, Compérat E, et al. European Guidelines on Upper Tract Urothelial Carcinomas: 2013 Update. Eur Urol. 2013;63:1059–71. doi: 10.1016/j.eururo.2013.03.032. - DOI - PubMed

[4] Rouprêt M, Babjuk M, Compérat E, et al. European Guidelines on Upper Tract Urothelial Carcinomas: 2013 Update. Eur Urol. 2013;63:1059–71. doi: 10.1016/j.eururo.2013.03.032. - DOI - PubMed

[5] Hanna N, Sun M, Trinh QD, et al. Propensity-score-matched comparison of perioperative outcomes between open and laparoscopic nephroureterectomy: A national series. Eur Urol. 2012;61:715–21. doi: 10.1016/j.eururo.2011.12.026. - DOI - PubMed

[6] Hanna N, Sun M, Trinh QD, et al. Propensity-score-matched comparison of perioperative outcomes between open and laparoscopic nephroureterectomy: A national series. Eur Urol. 2012;61:715–21. doi: 10.1016/j.eururo.2011.12.026. - DOI - PubMed

[7] Yu H-Y, Hevelone ND, Lipsitz SR, et al. Use, costs and comparative effectiveness of robotic assisted, laparoscopic and open urological surgery. J Urol. 2012;187:1392–9. doi: 10.1016/j.juro.2011.11.089. - DOI - PubMed

[8] Yu H-Y, Hevelone ND, Lipsitz SR, et al. Use, costs and comparative effectiveness of robotic assisted, laparoscopic and open urological surgery. J Urol. 2012;187:1392–9. doi: 10.1016/j.juro.2011.11.089. - DOI - PubMed

[9] Merseburger AS, Herrmann TR, Shariat SF, et al. EAU Guidelines on Robotic and Single-site Surgery in Urology. Eur Urol. 2013;64:277–91. doi: 10.1016/j.eururo.2013.05.034. - DOI - PubMed

[10] Merseburger AS, Herrmann TR, Shariat SF, et al. EAU Guidelines on Robotic and Single-site Surgery in Urology. Eur Urol. 2013;64:277–91. doi: 10.1016/j.eururo.2013.05.034. - DOI - PubMed

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Robot-assisted versus laparoscopic nephroureterectomy for upper-tract urothelial cancer: A population-based assessment of costs and perioperative outcomes

Affiliations

Robot-assisted versus laparoscopic nephroureterectomy for upper-tract urothelial cancer: A population-based assessment of costs and perioperative outcomes

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