Early Recurrence Patterns Following Totally Intracorporeal Robot-assisted Radical Cystectomy: Results from the EAU Robotic Urology Section (ERUS) Scientific Working Group

• Published in: European urology 2017-05, Vol.71 (5), p.723-726
• Main Authors: Collins, Justin W, Hosseini, Abolfazl, Adding, Christofer, Nyberg, Tommy, Koupparis, Anthony, Rowe, Edward, Perry, Matthew, Issa, Rami, Schumacher, Martin C, Wijburg, Carl, Canda, Abdullah E, Balbay, Melvin D, Decaestecker, Karel, Schwentner, Christian, Stenzl, Arnulf, Edeling, Sebastian, Pokupić, Saša, D’Hondt, Fredrik, Mottrie, Alexander, Wiklund, Peter N
• Format: Article
• Language: English
• Subjects: Aged; Bone Neoplasms - epidemiology; Bone Neoplasms - secondary; Carcinoma, Transitional Cell - secondary; Carcinoma, Transitional Cell - surgery; Cystectomy - methods; Disease-Free Survival; Early recurrence patterns; Europe; Female; Follow-Up Studies; Humans; Kaplan-Meier Estimate; Liver Neoplasms - epidemiology; Liver Neoplasms - secondary; Lung Neoplasms - epidemiology; Lung Neoplasms - secondary; Lymph Nodes - pathology; Lymphatic Metastasis; Male; Medicin och hälsovetenskap; Middle Aged; Neoplasm Recurrence, Local - epidemiology; Oncologic outcomes; Pelvis; Peritoneal Neoplasms - epidemiology; Peritoneal Neoplasms - secondary; Proportional Hazards Models; Robot-assisted radical cystectomy; Robotic Surgical Procedures - methods; Societies, Medical; Totally intracorporeal robot-assisted radical cystectomy; Urinary Bladder Neoplasms - pathology; Urinary Bladder Neoplasms - surgery; Urinary Diversion - methods; Urology
• ISSN: 0302-2838; 1873-7560; 1873-7560
• DOI: 10.1016/j.eururo.2016.10.030

Abstract Recurrence following radical cystectomy often occurs early, with >80% of recurrences occurring within the first 2 yr. Debate remains as to whether robot-assisted radical cystectomy (RARC) negatively impacts early recurrence patterns because of inadequate resection or pneumoperitoneum. We report early recurrence patterns among 717 patients who underwent RARC with intracorporeal urinary diversion at nine different institutions with a minimum follow-up of 12 mo. Clinical, pathologic, radiologic, and survival data at the latest follow-up were collected. Recurrence-free survival (RFS) estimates were generated using the Kaplan-Meier method, and Cox regression models were built to assess variables associated with recurrence. RFS at 3, 12, and 24 mo was 95.9%, 80.2%, and 74.6% respectively. Distant recurrences most frequently occurred in the bones, lungs, and liver, and pelvic lymph nodes were the commonest site of local recurrence. We identified five patients (0.7%) with peritoneal carcinomatosis and two patients (0.3%) with metastasis at the port site (wound site). We conclude that unusual recurrence patterns were not identified in this multi-institutional series and that recurrence patterns appear similar to those in open radical cystectomy series. Patient summary In this multi-institutional study, bladder cancer recurrences following robotic surgery are described. Early recurrence rates and locations appear to be similar to those for open radical cystectomy series.