Evidence map›Paper›PMID 41165824›Full record

ArticleWorld journal of urology2025

Robotic versus open radical cystectomy: factors influencing approach Selection, predictors of surgical Conversion and their implications for patient outcomes.

Filippo Dagnino, Edoardo Beatrici, Zhiyu Qian, Daniel Stelzl, Hanna Zurl, Stephan Korn, Klara Pohl, Andrea Piccolini, Guilherme Garcia, Marco Paciotti and 7 more

Abstract readComparative Study
PubMed Publisher
In one paragraph

Article in World journal of urology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–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

1 citing paper in PubMed.

  1. Review
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

17 authors.

Filippo Dagnino *Department of Urology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
Edoardo Beatrici *Department of Urology, Humanitas Research Hospital - IRCCS, Milan, Italy.
Zhiyu QianDepartment of Urology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
Daniel StelzlDepartment of Urology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
Hanna ZurlDepartment of Urology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
Stephan KornDepartment of Urology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
Klara PohlDepartment of Urology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
Andrea PiccoliniDepartment of Urology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
Guilherme GarciaDepartment of Urology, University of Sao Paulo, Sao Paulo, Brazil.
Marco PaciottiDepartment of Urology, Humanitas Research Hospital - IRCCS, Milan, Italy.
Rodolfo HurleDepartment of Urology, Humanitas Research Hospital - IRCCS, Milan, Italy.
Giovanni LughezzaniDepartment of Urology, Humanitas Research Hospital - IRCCS, Milan, Italy.
Nicolò M BuffiDepartment of Urology, Humanitas Research Hospital - IRCCS, Milan, Italy.
Adam S KibelDepartment of Urology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
Alexander P ColeDepartment of Urology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
Quoc-Dien TrinhDepartment of Urology, University of Pittsburgh, UPMC, Pittsburgh, PA, USA.
Timothy N ClintonDepartment of Urology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA. tclinton1@bwh.harvard.edu.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundRobot-assisted radical cystectomy (RARC) use for bladder cancer (BC) treatment is increasing, offering similar oncologic outcomes to open radical cystectomy (ORC) with better perioperative results. We assessed factors driving RARC selection, predictors of conversion to open surgery, and impacts on mortality and morbidity.

methodsWe retrospectively analyzed the National Cancer Database (NCDB) (2010–2021) for patients with localized BC undergoing RARC versus ORC. Proportions in approach use were assessed, and multivariable logistic regression identified predictors of approach selection. RARC conversion rates and conversion predictors were analyzed. 30-/90-day mortality and 30-day readmission were compared between converted and non-converted cases using adjusted odds ratios (aOR) and 95% confidence intervals (CI).

resultsAmong 29,215 patients with localized BC, 9,954 (34.1%) underwent RARC. Usage rose from 18.1% in 2010 to 48.7% in 2021 (p < 0.001), highest in non-muscle invasive BC (NMIBC) (36.0%; p < 0.001). Predictors of RARC adoption over ORC included NMIBC diagnosis (aOR 1.22, 95% CI 1.10–1.35), neoadjuvant chemotherapy (1.49, 1.34–1.66), and private insurance (1.68, 1.32–2.16). RARC usage was less likely for cN2-3 (0.73, 0.61–0.86) and prior radiation (0.60, 0.43–0.85). Among RARC cases, 288 (2.9%) required intraoperative conversion to open surgery. Low-volume centers (< 10 cases: 2.33, 1.66–3.28; 10–19 cases: 1.89, 1.26–2.83) had higher conversion risk. Converted cases had significantly higher 90-day (11.9% vs. 5.1%; 2.53, 1.72–3.72) mortality and 30-day readmission (14.3% vs. 8.5%; 1.79, 1.28–2.51).

conclusionsRARC use increased, especially in NMIBC cases. Its adoption was driven by NMIBC diagnosis, neoadjuvant chemotherapy, and insurance; low caseload predicted conversion to open surgery and worse outcomes, informing patient selection.

Indexed as

Conversion to Open SurgeryCystectomyRobotic Surgical ProceduresUrinary Bladder NeoplasmsAgedFemaleHumansMaleMiddle AgedRetrospective StudiesTreatment OutcomeBladder cancerConversionOpen approachRadical cystectomyRobotic approach

Identifiers

PMID41165824

What OpenQuestion holds

Textmetadata
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Registered trials

None linked

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.