Helping Pave the Way in Bladder Cancer Treatment and Care

University of Minnesota researchers study the preferred technique for cystectomy, or bladder removal- robotic-assisted radical cystectomy versus the traditional approach of open radical cystectomy. It turns out, while there are advantages to the robotic technique, there were not significant differences between the two. Dr. Badrinath Konety, CEO of University of Minnesota Physicians and Vice Dean for Clinical Affairs at the University of Minnesota Medical School, was part of a large, collaborative effort involving more than 9,700 patients with urothelial bladder cancer (BCa) treated at 25 institutions. The study assessed the effects of each surgical approach on survival outcomes.

Researchers found that by doing this procedure with a robot, patients were typically able to go home earlier (shorter length of stay at the hospital) and on average, lost less blood and reported slightly less pain. 

“This is such a complicated operation, and there are so many things that can influence the outcome. So while these three factors do make a difference, collectively, that difference may not be hugely noticeable,” explained Konety. “The big message is the outcome is not worse or riskier with a robotic-assisted radical cystectomy.”

This information is helpful when consulting patients until further long-term survival outcomes evidence is available.

Open Versus Robotic Cystectomy: A Propensity Score Matched Analysis Comparing Survival Outcomes is available to read in its entirety in UroToday.

Konety was also featured in Urology Times to comment on a new trial regarding a treatment combining the immunotherapy atezolizumab (Tecentriq) and platinum-based chemotherapy. 

“The interim analysis is clearly exciting and the approach is valid. This opens up the opportunity for using immunotherapy in a broader group of patients—even those who can tolerate chemotherapy. And if this combination ultimately does turn out to be positive and yield a survival benefit, it could potentially become standard of care in these patients,” Konety said in the article.

Konety was not involved in the clinical trial discussed in Urology Times, which is being done in patients with previously untreated locally advanced or metastatic urothelial cancer. However, he and his colleagues have been involved in other related efforts and studies.

Prior to this trial, treatment combining immunotherapy and chemotherapy has been used in patients with very advanced stages of the disease, when all other treatment options have been tried and failed. It’s shown to be effective there (to increase cure rates), as well as in patients slightly less advanced with this treatment acting as their first.

“At the U of M Medical School, we have one of the first trials that looks at giving this treatment to patients even earlier- where the cancer has invaded the wall of the bladder but is not beyond the bladder yet,” said Konety, who is co-leading these efforts. They are in the process of getting the data now.

Konety says they are also using the treatment in people with whom the cancer has not yet invaded the bladder wall to see if they can decrease or prevent it from invading the wall of the bladder.

“This is evolving to become the standard of care, and I think this could be a real benefit to our patients,” said Konety.