Comparison of Complication and Readmission Rates Between Robot-Assisted and Open Radical Cystectomy: Results From the Randomized RAZOR Clinical Trial

Abstract

Purpose: We assessed differences in complications and readmissions between robot-assisted radical cystectomy (RARC) and open radical cystectomy (ORC). Materials and Methods: This study uses data from the per-protocol population of the Randomized Robotic-Assisted vs Open Radical Cystectomy (RAZOR) study, a multicenter, open-label, phase 3, noninferiority clinical trial. RAZOR enrolled across 15 academic medical centers in the United States between 2011 and 2014. The median follow-up was 2 years. Complications up to 90 days using the Clavien-Dindo classification, and readmissions at 90 days and 1 year postoperatively were compared. Multivariable logistic regression analyses were performed to determine any predictors of major complications and of postsurgery readmission. Results: Baseline characteristics were similar, and there was no significant difference in overall and major complication rates between RARC (n = 150) and ORC (n = 152) arms. Simplified frailty index ≥ 3 (HR, 4.22, 95% CI, 2.67-6.66, P