AUA 2017: Comparison of total 90 day costs for open versus robotic cystectomy

Boston, MA ( In this study analyzing the cost of extirpative treatment for bladder cancer, the investigators from UT MD Anderson Cancer Center retrospectively analyzed the cost of surgery and postoperative care in 100 pair wise matched open vs. robotic assisted radical cystectomy patients. The two groups had similar clinicopathologic features, neoadjuvant chemotherapy rates, and pathologic staging at RC. Robotic assisted radical cystectomy was found to be more costly overall. Not surprisingly, most of the higher cost for RARC was found on the day of the operation. Furthermore, the cumulative cost remained higher than open radical cystectomy throughout the followup period of 90 days. The authors did find a decreased hospital length of stay, number of complications, blood loss and need for transfusions in the robotic assisted group.

The study excluded patients undergoing neobladder creation as these patients are known to have higher rates of complication postoperatively, and may introduce bias in the comparative analysis. In addition, the investigators matched patients in both groups according to the year of surgery, in order to eliminate differences introduced in the postoperative protocol that may have affected hospital length of stay and complication rates. In the current cost-driven environment we operate, this study serves as an important benchmark for future practice in the care of patients with bladder cancer.

Presented by: Michael J. Metcalfe, MD

Written By: Roger Li MD Urologic Oncology Fellow, UT MD Anderson Cancer Center
Ashish M. Kamat MD Wayne B. Duddlesten Professor, UT MD Anderson Cancer Center

at the 2017 AUA Annual Meeting - May 12 - 16, 2017 – Boston, Massachusetts, USA