For bladder cancer patients, laparoscopic surgery has good outcomes

For bladder cancer patients, laparoscopic surgery has good outcomes

23 Dec 2014

Outcomes after laparoscopic surgery for bladder cancer patients are comparable to open surgery: after 5 years, 66% of patients had no signs of recurrence. This is the result of the largest analysis of its kind, of procedures performed across Europe.

The findings indicate that prospective randomized trials comparing these two bladder cancer surgeries are warranted.

Radical cystectomy: the main difference between open and laparoscopic procedures

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; however, 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.

Analysis of 500 patients

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.

Good results for 2 in 3 patients, five years after the operation

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.

"When performed correctly, can be as safe as open surgery"

"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 a robot.

Laparoscopic equipment, on the other hand, is more widely available.

“As such, this data represents 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.

 

Source: eCancer News