Oncologic Outcomes and Predictive Factors for Recurrence Following Robot-Assisted Radical Cystectomy for Urothelial Carcinoma: Multicenter Study from Korea.
Ji Sung ShimTae Gyun KwonKoon Ho RhaYoung Goo LeeJi Youl LeeByung Chang JeongJae Yoon KimJong Hyun PyunSung Gu KangSeok Ho KangPublished in: Journal of Korean medical science (2018)
The aim of our study was to evaluate intermediate-term oncologic outcomes, predictive factors for recurrence, and recurrence patterns in a multicenter series of patients treated with robot-assisted radical cystectomy (RARC) for urothelial carcinoma (UC) of the bladder. Between 2007 and 2015, 346 patients underwent RARC at multiple tertiary referral centers in Korea. Descriptive statistics were used for demographics and perioperative variables. Survival and recurrence were estimated with Kaplan-Meier analysis. Logistic regression models were used to determine predictors of recurrence. Median follow-up was 33 months (interquartile range [IQR], 7-50). The numbers of patients with organ-confined and lymph node (LN)-positive disease were 237 (68.4%) and 68 (19.7%), respectively. LN density (1-20 vs. > 20) was 13.6% and 6.1%, with a median of 17 nodes removed (IQR, 9-23). In logistic regression analysis, type of LN dissection, and pathologic tumor stage were significant predictors of cancer recurrence and death from cancer. Local, distal recurrence and secondary UC occurred in 7 (2.0%), 53 (15.3%), and 4 (1.2%) patients, respectively. The 5-year overall survival (OS), cancer-specific survival (CSS), and recurrence-free survival (RFS) were 78%, 84%, and 73%, respectively. At last follow-up, RFS for extended pelvic LN dissection vs. standard pelvic LN dissection was 70% and 47% (P = 0.038). In addition, at last follow-up, LN density (0 vs. 1-20 vs. over 20) was 67%, 41%, and 29%, respectively (P < 0.001). Patients undergoing RARC in this multi-institutional cohort demonstrated intermediate-term oncologic outcomes, predictive factors for recurrence, and recurrence patterns that were not unusual.
Keyphrases
- free survival
- robot assisted
- patients undergoing
- lymph node
- end stage renal disease
- minimally invasive
- ejection fraction
- rectal cancer
- papillary thyroid
- chronic kidney disease
- prostate cancer
- acute kidney injury
- prognostic factors
- type diabetes
- radical prostatectomy
- skeletal muscle
- spinal cord injury
- young adults
- early stage
- radiation therapy
- metabolic syndrome
- patient reported outcomes
- sentinel lymph node
- insulin resistance
- lymph node metastasis
- gestational age
- childhood cancer