Cancer - Bladder, Pelvis, Ureter & Others(구연) (E-048) 방광암 환자에서 로봇 보조 방광 전 적출술 후 pentafecta 적용 여부에 따른 oncological outcome 의 변화 : KORARC data base 분당서울대병원 비뇨의학과 교실 이재원1, 오종진1,2 , 이상철1, 구자현2,3, 권태견4, 김태환4, 전성현5, 이상협5, 남종길6, 김완석7, 정병창8, 이지율9, 홍성호9, 나군후10, 한용규10, 함원식10, 이용구11, 이용성12, 박성열13, 윤용은13, 강성구14, 강석호14* Objectives To investigate the oncological significance of robot assisted radical cystectomy (RARC)-related pentafecta among patients with bladder cancer. Patients and methods Using the KORAC database (containing data from 12 centers), data from 730 patients who underwent RARC between April 2007 and May 2019 were prospectively collected and analyzed. Pentafecta was achieved if patients met all of the following criteria: 1) negative surgical margin, 2) ≥ 16 Lymph node (LN) removed, 3) no major complications (Clavien-Dindo grade 3-5) within 90 days and 4) no clinical recurrence within the first 12 months and 5) no uretero-enteric stricture. Patients were divided into two groups according to pentafecta attainment and followed by a comparison of overall survival (OS) and cancer specific survival (CSS) using the multivariate Cox proportional analysis Results Among the 730 patients included in this analysis, 208 (28.5%) attained RARC-pentafecta; the remaining 522 (71.5%) did not. The mean age of subjects was 64.67 years, 85.1% were males with bladder cancer, 53.6% received a conduit, 37.7% received orthotopic neobladders and the total complication rate was 57.8%. Those who attained pentafecta 1) received more neobladders (p=0.039), 2) were more likely to be treated with the intracorporeal technique (p < 0.001), 3) had longer operating times (p=0.020) and 4) had longer console time (p = 0.021) compared with those who did not attain pentafecta. Over a mean of 31.1 months of follow up, the pentafecta attainment group had significantly higher OS and CSS rates compared with the not-attaiment group, respectively [10 year OS: 70.4% vs. 58.1%, respectively (p=0.016); 10 year CSS: 87.8% vs. 70.0% (p = 0.036)]. Multivariate analysis revealed that RARC-pentafecta was a significant predictor of overall death (HR = 0.561, p = 0.038). Conclusions Patients who attained RARC-pentafecta had significant better survival outcomes compared with those who did not attain pentafecta. Our criteria could be the guideline to standard the surgical quality of RARC. In the future, a similar study using an independent cohort is warranted to help confirm the results achieved here. keywords : bladder cancer, robot cystectomy, survival