{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,11]],"date-time":"2026-10-11T17:46:34Z","timestamp":1791740794859,"version":"4.3.4"},"reference-count":21,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2026,10,11]],"date-time":"2026-10-11T00:00:00Z","timestamp":1791676800000},"content-version":"vor","delay-in-days":10,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Medicine"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To examine how the age distribution of radical prostatectomy and radical cystectomy changed in Japan during the period in which robot\u2010assisted surgery spread.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We used the National Database Open Data for fiscal years 2014 to 2024 (Japanese fiscal year, April to March). Procedures were identified by procedure code and classified as robot\u2010assisted or conventional. Rates per 100,000 population were calculated, and the rate in each age group was expressed relative to that in patients aged 70 to 74\u2009years. Cells with fewer than 10 claims are suppressed in the source tables; sensitivity analyses imputed 0, 5 or 9 procedures into these cells.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Radical prostatectomy increased from 20,222 to 29,239 procedures and radical cystectomy from 3545 to 4793. Rates in patients younger than 75\u2009years rose only about 1.2\u2010fold. For prostatectomy, the rate ratio in men aged 75 to 79\u2009years rose from 0.40 to 0.93, while that in men aged 80 to 84\u2009years reached only 0.22. For cystectomy, the ratio in patients aged 80 to 84\u2009years rose from 0.74 to 0.95, while no clear increase was seen in patients aged 85\u2009years or older (0.18 to 0.20,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.791). In men aged 80\u2009years or older, robot\u2010assisted prostatectomy increased from 94 to 1239 procedures, whereas conventional surgery changed from 64 to 97. These findings were unchanged when suppressed cells were imputed as 5 or 9.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Between fiscal years 2014 and 2024, the age distribution of radical prostatectomy and radical cystectomy in Japan shifted toward older patients. The increase was concentrated in men aged 75 to 84\u2009years for prostatectomy and in patients aged 80 to 84\u2009years for cystectomy, and was accounted for mainly by robot\u2010assisted procedures.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/cam4.72370","type":"journal-article","created":{"date-parts":[[2026,10,11]],"date-time":"2026-10-11T17:15:03Z","timestamp":1791738903000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Changes in the Age Distribution of Radical Prostatectomy and Radical Cystectomy During the Diffusion of Robot\u2010Assisted Surgery in Japan"],"prefix":"10.1002","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4945-7023","authenticated-orcid":false,"given":"Taku","family":"Mochizuki","sequence":"first","affiliation":[{"name":"Departments of Urology and Renal Transplantation Yokohama City University Medical Center  Yokohama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7049-3379","authenticated-orcid":false,"given":"Takashi","family":"Kawahara","sequence":"additional","affiliation":[{"name":"Departments of Urology and Renal Transplantation Yokohama City University Medical Center  Yokohama Japan"},{"name":"Department of Urology Yokohama City University, Graduate School of Medicine  Yokohama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-1054-0779","authenticated-orcid":false,"given":"Akihito","family":"Hashizume","sequence":"additional","affiliation":[{"name":"Departments of Urology and Renal Transplantation Yokohama City University Medical Center  Yokohama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masanobu","family":"Yamazaki","sequence":"additional","affiliation":[{"name":"Departments of Urology and Renal Transplantation Yokohama City University Medical Center  Yokohama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2733-5487","authenticated-orcid":false,"given":"Teppei","family":"Takeshima","sequence":"additional","affiliation":[{"name":"Departments of Urology and Renal Transplantation Yokohama City University Medical Center  Yokohama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7943-1564","authenticated-orcid":false,"given":"Hiroji","family":"Uemura","sequence":"additional","affiliation":[{"name":"Departments of Urology and Renal Transplantation Yokohama City University Medical Center  Yokohama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7449-2015","authenticated-orcid":false,"given":"Kazuhide","family":"Makiyama","sequence":"additional","affiliation":[{"name":"Department of Urology Yokohama City University, Graduate School of Medicine  Yokohama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1499-546X","authenticated-orcid":false,"given":"Jun\u2010ichi","family":"Teranishi","sequence":"additional","affiliation":[{"name":"Departments of Urology and Renal Transplantation Yokohama City University Medical Center  Yokohama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,11]]},"reference":[{"issue":"10049","key":"e_1_2_12_2_1","doi-asserted-by":"crossref","first-page":"1057","DOI":"10.1016\/S0140-6736(16)30592-X","article-title":"Robot\u2010Assisted Laparoscopic Prostatectomy Versus Open Radical Retropubic Prostatectomy: Early Outcomes From a Randomised Controlled Phase 3 Study","volume":"388","author":"Yaxley J. W.","year":"2016","journal-title":"Lancet"},{"issue":"8","key":"e_1_2_12_3_1","doi-asserted-by":"crossref","first-page":"1051","DOI":"10.1016\/S1470-2045(18)30357-7","article-title":"Robot\u2010Assisted Laparoscopic Prostatectomy Versus Open Radical Retropubic Prostatectomy: 24\u2010Month Outcomes From a Randomised Controlled Study","volume":"19","author":"Coughlin G. D.","year":"2018","journal-title":"Lancet Oncology"},{"issue":"10139","key":"e_1_2_12_4_1","doi-asserted-by":"crossref","first-page":"2525","DOI":"10.1016\/S0140-6736(18)30996-6","article-title":"Robot\u2010Assisted Radical Cystectomy Versus Open Radical Cystectomy in Patients With Bladder Cancer (RAZOR): An Open\u2010Label, Randomised, Phase 3, Non\u2010Inferiority Trial","volume":"391","author":"Parekh D. J.","year":"2018","journal-title":"Lancet"},{"issue":"12","key":"e_1_2_12_5_1","doi-asserted-by":"crossref","first-page":"1512","DOI":"10.1001\/jamaoncol.2025.4125","article-title":"Active Monitoring, Surgery, and Radiotherapy for Cribriform\u2010Positive and Cribriform\u2010Negative Prostate Cancer: A Secondary Analysis of the PROTECT Randomized Clinical Trial","volume":"11","author":"Sushentsev N.","year":"2025","journal-title":"JAMA Oncology"},{"issue":"5","key":"e_1_2_12_6_1","doi-asserted-by":"crossref","first-page":"582","DOI":"10.1016\/j.eururo.2025.02.019","article-title":"European Association of Urology Guidelines on Muscle\u2010Invasive and Metastatic Bladder Cancer: Summary of the 2025 Guidelines","volume":"87","author":"Heijden A. 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R.","year":"2023","journal-title":"Lancet Oncology"},{"issue":"6","key":"e_1_2_12_8_1","doi-asserted-by":"crossref","first-page":"e0234113","DOI":"10.1371\/journal.pone.0234113","article-title":"Comparison of Perioperative Outcomes in Elderly (Age \u226575\u2009Years) vs. Younger Men Undergoing Robot\u2010Assisted Radical Prostatectomy","volume":"15","author":"Yamada Y.","year":"2020","journal-title":"PLoS One"},{"issue":"10","key":"e_1_2_12_9_1","doi-asserted-by":"crossref","first-page":"729.e17","DOI":"10.1016\/j.urolonc.2020.12.001","article-title":"Oncologic and Patient\u2010Reported Outcomes After Robot\u2010Assisted Radical Prostatectomy in Men Aged >\/=75\u2009Years","volume":"39","author":"Togashi K.","year":"2021","journal-title":"Urologic Oncology"},{"issue":"11","key":"e_1_2_12_10_1","doi-asserted-by":"crossref","first-page":"1014","DOI":"10.1111\/iju.15250","article-title":"Surgical Outcomes of Robot\u2010Assisted Radical Cystectomy in Octogenarian or Older Patients: A 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Surgical Outcomes Among Surgical Approaches Focusing on Robot\u2010Assisted Radical Cystectomy: A Japanese Nationwide Database Study","volume":"30","author":"Chen W.","year":"2023","journal-title":"International Journal of Urology"},{"issue":"12","key":"e_1_2_12_14_1","doi-asserted-by":"crossref","first-page":"1344","DOI":"10.1111\/iju.15561","article-title":"The First Detailed Annual Record on the National Clinical Database Urology Division in Japan: A Report on Five Surgical Procedures","volume":"31","author":"Kikuchi E.","year":"2024","journal-title":"International Journal of Urology"},{"issue":"2","key":"e_1_2_12_15_1","doi-asserted-by":"crossref","first-page":"58","DOI":"10.37737\/ace.23008","article-title":"A Review of Studies Using Japanese Nationwide Administrative Claims Databases","volume":"5","author":"Sato S.","year":"2023","journal-title":"Annals of Clinical 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J.","year":"2024","journal-title":"Journal of Magnetic Resonance Imaging"}],"container-title":["Cancer Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/cam4.72370","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/cam4.72370","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/cam4.72370","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,11]],"date-time":"2026-10-11T17:15:06Z","timestamp":1791738906000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/cam4.72370"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10]]},"references-count":21,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2026,10]]}},"alternative-id":["10.1002\/cam4.72370"],"URL":"https:\/\/doi.org\/10.1002\/cam4.72370","archive":["Portico"],"relation":{},"ISSN":["2045-7634","2045-7634"],"issn-type":[{"value":"2045-7634","type":"print"},{"value":"2045-7634","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10]]},"assertion":[{"value":"2026-08-17","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-10-03","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-10-11","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e72370"}}