Evidence map›Paper›PMID 30366043›Full record

Trial reportUrology2019

Real-World Impact of Minimally Invasive Versus Open Radical Cystectomy on Perioperative Outcomes and Spending.

Parth K Modi, Brent K Hollenbeck, Mary Oerline, Alon Z Weizer, Jeffrey S Montgomery, Samuel D Kaffenberger, Andrew M Ryan, Chad Ellimoottil

Abstract readComparative StudyMulticenter StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Urology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Review
  4. Article
  5. Article
  6. Article
  7. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Parth K ModiDepartment of Urology, Division of Urologic Oncology, University of Michigan, Ann Arbor, MI; Department of Urology, Division of Health Services Research, University of Michigan, Ann Arbor, MI. Electronic address: pamodi@med.umich.edu.
Brent K HollenbeckDepartment of Urology, Division of Urologic Oncology, University of Michigan, Ann Arbor, MI; Department of Urology, Division of Health Services Research, University of Michigan, Ann Arbor, MI.
Mary OerlineDepartment of Urology, Division of Health Services Research, University of Michigan, Ann Arbor, MI.
Alon Z WeizerDepartment of Urology, Division of Urologic Oncology, University of Michigan, Ann Arbor, MI.
Jeffrey S MontgomeryDepartment of Urology, Division of Urologic Oncology, University of Michigan, Ann Arbor, MI.
Samuel D KaffenbergerDepartment of Urology, Division of Urologic Oncology, University of Michigan, Ann Arbor, MI.
Andrew M RyanDepartment of Health Management and Policy, University of Michigan, Ann Arbor, MI.
Chad EllimoottilDepartment of Urology, Division of Health Services Research, University of Michigan, Ann Arbor, MI.

Funding

Advanced Training in Urologic OncologyT32CA180984 · NCI · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI Ganesh S Palapattu, VAHAKN B SHAHINIAN · 2014 to 2026
$3.4M
Major surgery in patients with Alzheimer's disease and related dementias: effects of technology and policyR01AG048071 · NIA · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI HOLLENBECK, BRENT K. · 2015 to 2019
$3.0M
Impact of the Dissemination of Surgical Technology on Cancer Surgery OutcomesF32CA232332 · NCI · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI MODI, PARTH KIRAN · 2018 to 2018
$74k
NCI NIH HHS F32 CA232332NCI NIH HHS T32 CA180984NIA NIH HHS R01 AG048071
6 · The paper itself

Abstract

objectiveTo evaluate the effect of the minimally invasive approach on spending and perioperative outcomes for patients undergoing radical cystectomy for bladder cancer. In a randomized control trial conducted at high-volume centers, robotic, and open cystectomy were shown to have similar outcomes. However, because the majority of cystectomies are performed in low-volume centers, it is unknown whether these findings are broadly generalizable. MATERIALS AND

methodsWe identified Medicare patients who underwent radical cystectomy for bladder cancer between 2008 and 2015. We examined the length of stay, readmission rate, and 90-day spending after minimally invasive or open cystectomy. We used multiple regressions to estimate the association between minimally invasive surgery and the outcomes, accounting for patient, hospital, and surgeon factors that may influence these outcomes.

resultsOf 4760 patients, 693 (14.6%) underwent minimally invasive cystectomy and 4067 (85.4%) had an open approach. Minimally invasive cystectomy was associated with shorter length of stay (10.1 days vs 11.9 days, P <.001), but no difference in readmission rate (27.4% vs 26.8%, P = .77). Minimally invasive cystectomy was associated with lower adjusted 90-day episode spending ($34,369 vs $38,071, P <.001).

conclusionIn patients across diverse institutions in the United States, minimally invasive cystectomy was associated with a shorter length of stay than open cystectomy and reduced 90-day episode spending, but with no significant difference in readmission rate.

Indexed as

AgedAged, 80 and overCystectomyFemaleHumansMaleMinimally Invasive Surgical ProceduresTreatment OutcomeUrinary Bladder Neoplasms

Identifiers

PMID30366043
PMCPMC6389393

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.