Details

Autor(en) / Beteiligte

• Kubota, Masashi
• Kokubun, Hidetoshi
• Yamaguchi, Ritsuki
• Murata, Shiori
• Makita, Noriyuki
• Suzuki, Issei
• Suzuki, Ryosuke
• Abe, Yohei
• Tohi, Yoichiro
• Tsutsumi, Naofumi
• Sugino, Yoshio
• Inoue, Koji
• Kawakita, Mutsushi

Titel

Atypical oncologic failure after laparoscopic and robot-assisted radical cystectomy at a single institution

Ist Teil von

• International journal of clinical oncology, 2020-07, Vol.25 (7), p.1385-1392

Ort / Verlag

Singapore: Springer Singapore

Erscheinungsjahr

2020

Quelle

SpringerLink

Beschreibungen/Notizen

• Background The incidence of atypical oncologic failure in patients with bladder cancer, including peritoneal carcinomatosis, and recurrences at the port site and soft tissue after laparoscopic and robot-assisted radical cystectomy are not well characterized. Methods We retrospectively reviewed the records of 52, 51, and 12 patients who underwent open, laparoscopic, and robot-assisted radical cystectomy, respectively, for bladder cancer from 2007 to 2018 at our institution. We identified techniques associated with atypical oncologic failure. Results The median follow-up period was 29 months. Among the 115 patients, 29 (25%) experienced oncological recurrences, and 7 (6%), 12 (10%), and 23 (20%) had atypical, local, and distant recurrences, respectively. The laparoscopic and robot-assisted radical cystectomy groups had significantly higher incidences of total atypical oncologic failure than the open radical cystectomy group ( p  = 0.013), including six, one, and two patients with peritoneal carcinomatosis, port site carcinomatosis, and soft tissue involvement, respectively. All 7 patients with atypical oncologic failure died of cancer; the median time from surgery to death was 9.3 months. All these patients were cT ≧ 3 and had grade 3 disease. In three patients (43%), the pathological tissue contained variants other than urothelial carcinoma. Five (71%) were among the initial twenty patients. Four patients (57%) had histories of intraoperative urine spillage or bladder perforation during transurethral resection. Conclusions Patients with cT ≧ 3 stage, with pathological variants other than urothelial carcinoma, and those undergoing procedures that lead to extravesical dissemination should avoid laparoscopic radical cystectomy when the procedures are first introduced.