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Miller et al. Mini-invasive Surg 2021;5:24 https://dx.doi.org/10.20517/2574-1225.2021.25 Page 7 of 12

Table 3. Recurrence patterns from selected studies

Atypical recurrence c

Surgical Cases Local a Distant b Peritoneal Abdominal Extra pelvic Significantly
Ref. Year recurrence , recurrence , n carcinomatosis, n wall/port site, lymph nodes, Comments
approach (n) n (%) (%) (%) n (%) n (%) different?

Comparative studies, randomized
[6,7]
RAZOR trial, multiple authors 2020, ORC 152 3 (2.0) 25 (16.4) 1 (0.7) 1 (0.7) 9 (5.9) No Largest RCT to date
2018
RARC 150 6 (4.0) 22 (14.7) 2 (1.3) 0 9 (6.0)
[8]
CORAL trial, Khan et al. 2020 ORC 20 3 (15.0) nr nr nr nr No Small sample size. Distant
recurrences reported in
RARC 20 3 (15.0) nr nr nr nr
aggregate only, not shown here
LRC 19 3 (15.7) nr nr nr nr
[9] d
Bochner et al. 2018 ORC 58 5 (8.6) 27 (46.6) 2 (3.4) 0 10 (17.2) No Not powered to detect
differences in recurrence
RARC 60 17 (28.3) 20 (33.0) 2 (3.3) 5 (8.3) 5 (8.3)
patterns
Comparative studies, non-randomized
[16]
Faraj et al. 2019 ORC 278 19 (7) 64 (23) 5 (1.8) 0 11 (4.0) No Large single institutional study
RARC 203 12 (6) 40 (20) 4 (2.0) 0 4 (2.0)
[21]
Tan et al. 2016 ORC 90 17 (19) 25 (28) 3 (3) 1 (1) 2 (2) No Intracorporeal diversions in all
robotic cases
RARC 94 11 (12) 8 (9) 2 (2) 1 (1) 3 (3)
[23]
Nguyen et al. 2015 ORC 79 15/65 (23) 26/73 (36) 2/26 (8) nr 4/26 (15) Yes Denominator is distant
recurrence, as listed in the
RARC 158 24/136 (18) 43/147 (29) 9/43 (21) nr 10/43 (23)
reference
Non-comparative studies
[25]
IRCC, Elsayed et al. 2021 RARC only 2107 241 (11) 382 (18) 26 (1.2) 25 (1.2) 109 (5.2) n/a RARC not associated with
different patterns or higher
recurrence relative to historic
ORC series
[27]
IRCC, Hussein et al. 2019 RARC only 446 69 (15) 97 (22) 6 (1) 5 (1) 21 (5) n/a Analysis restricted to patients
with > 10 years follow up
[29]
Collins et al. 2017 RARC, ICUD 717 78 (10.7) 128 (17.8) 5 (0.7) 2 (0.3) 47 (6.6) n/a Totally intracorporeal urinary
only diversion cohort

a b c
Local recurrence defined as any recurrence in the cystectomy bed or lymph node dissection template. Distant recurrence defined as any recurrence which is not local or atypical. Though sometimes reported in the
d
referenced studies as a subset of distant recurrences, atypical recurrences reported here are mutually exclusive of local and distant recurrence. “The difference in local recurrence rates did not meet conventional
levels of significance (sHR = 0.36; 95%CI: 0.11-1.12, P = 0.077). Similarly, the difference in the rate of abdominal recurrence did not reach statistical significance (sHR = 0.38; 95%CI:0.07-1.96; P = 0.2). However,
when the pelvic and abdominal recurrences were combined into a single group representing local/regional recurrence, the ORC group showed significantly less local/regional recurrence compared to RARC (sHR =
0.34; 95%CI: 0.12-0.93; P = 0.035)”. RAZOR: randomized open vs. robotic cystectomy; ORC: open radical cystectomy; RARC: robotic assisted radical cystectomy; RCT: randomized controlled trial; CORAL:
controlled three-arm trial of open, robotic, and laparoscopic radical cystectomy; IRCC: International Robotic Cystectomy Consortium; ICUD: intracorporeal urinary diversion; nr: not reported.