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Laparoscopic Surgery for Bladder Cancer Leads to Good Long-Term Cancer Control

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Key Points

  • At 5-years follow-up, recurrence-free survival was 66% in patients treated with laparoscopic radical cystectomy.
  • Among those patients followed for 10 years, 6% had no signs of cancer recurrence.
  • The findings support the use of a laparoscopic approach for the management of bladder cancer.

Long-term survival rates following laparoscopic surgery for bladder cancer are comparable to those of open surgery, according to a study published in BJU International. The findings, which come from the largest study to date with long-term follow-up after this type of minimally invasive surgery, indicate that prospective randomized trials comparing these two bladder cancer surgeries are warranted.

Open radical cystectomy, or removal of the bladder though open surgery, is the treatment of choice for muscle invasive and high-risk non–muscle invasive bladder cancer, but the surgery can lead to serious complications. Some hospitals are using minimally invasive procedures such as laparoscopic radical cystectomy, but there is little information on the effectiveness of these procedures for preventing cancer recurrence over the long term.

Study Details

To address this, the European Association of Urology (EAU)-section of Uro-technology has been building a large database of laparoscopic radical cystectomy procedures performed across Europe. When exploring this database, an international team led by Simone Albisinni, MD, and Roland van Velthoven, MD, PhD, of the Université Libre de Bruxelles in Belgium, found that laparoscopic radical cystectomy can lead to reliable cancer control even many years after surgery. After 5 years, 66% of patients had no signs of bladder cancer recurrence, and among those followed for 10 years, 62% had no signs of recurrence.

“Analyzing over 500 patients and with a median follow-up of 5 years, these results are vital to globally evaluate the efficacy of this procedure. They suggest that a laparoscopic approach to bladder cancer, when performed correctly, can be as safe as open surgery with regards to cancer control, though maintaining the benefits of a minimally invasive approach,” said Dr. Albisinni.

The authors noted that there is growing interest for robotic-assisted radical cystectomy, another minimally invasive procedure, in the international community as well; however, many hospitals in Europe do not own robotic platforms. Laparoscopic equipment, on the other hand, is more widely available. “As such, these data represent crucial information for urologists who are performing laparoscopic surgery, or who wish to implement laparoscopic cystectomy in their departments. In spite of the technical difficulty and the need for a learning curve, these findings support the use of a laparoscopic approach for the management of bladder cancer,” said Dr. Albisinni.

Dr. Albisinni is the corresponding author for the BJU International article.

The study authors reported no potential conflicts of interest.

The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.


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