• Lin Dong, Feng Xiaoli, Lu Ya, Wu Dan, Hu Jingwen, Liu Xun, Chen Shujin, Zhou Zhijun, Zhang Tian, Luo Hao, Yi Chuanlang, Chen Guangrong, Wang Xiaodong, Luo Gewen, Zhang Yichi, Cao Pei, Liu Yang, and Wang Youliang.
• Department of Urology, Pengzhou People's Hospital, Chengdu, Sichuan, China.
• Medicine (Baltimore). 2022 Aug 26; 101 (34): e30291.

BackgroundTo understand the long-term oncologic outcomes of open radical cystectomy (ORC) versus laparoscopic radical cystectomy (LRC) versus robot-assisted radical cystectomy (RARC) for bladder cancer (BCa). Therefore, we performed the conventional meta-analysis and network meta-analysis to evaluate the long-term oncologic outcomes of ORC, LRC, and RARC for BCa.MethodsA systematic search of PubMed, Embase, Cochrane Library, Medline, and Web of science was performed up until July 1, 2021. Long-term oncologic outcomes include the 5-year overall survival (OS) rate, the 5-year recurrence-free survival (RFS) rate, and the 5-year cancer specific-survival (CSS) rate. The Bayesian network analysis has been registered in PROSPERO (CRD42020208396).ResultsWe found that 10 articles (including 3228 patients) were included in our Bayesian network analysis. No significant differences were found between ORC, LRC, and RARC in long-term oncologic outcomes in either direct meta-analysis or network meta-analysis. Therefore, the clinical effects of 5-year OS, RFS, and CSS of RARC, LRC, and ORC are similar. But LRC may be ranked first in 5-year OS, RFS, and CSS compared to other surgical approaches by probabilistic analysis ranking via Bayesian network analysis.ConclusionWe found that there were no statistical differences in the 3 surgical approaches of RAPC, LPC, and OPC for Bca in long-term oncologic outcomes by direct meta-analysis. However, Subtle differences between these surgical approaches can be concluded that LRC may be a better surgical approach than RARC or ORC in long-term oncologic outcomes by probabilistic analysis ranking via Bayesian network analysis. Moreover, we need a large sample size and more high-quality studies to improve and verify further.Copyright © 2022 the Author(s). Published by Wolters Kluwer Health, Inc.

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