Factors Impacting the Occurrence of Local, Distant and Atypical Recurrences after Robot-Assisted Radical Cystectomy: A Detailed Analysis of 310 Patients
| Autor: | Douglas S. Scherr, Padraic O'Malley, Daniel P. Nguyen, David M. Golombos, Patrick Lewicki, Farehin Khan |
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| Rok vydání: | 2016 |
| Předmět: |
Male
medicine.medical_specialty Blood transfusion Lymphovascular invasion Urology medicine.medical_treatment 030232 urology & nephrology Renal function Cystectomy 03 medical and health sciences 0302 clinical medicine Robotic Surgical Procedures medicine Humans Lymph node Peritoneal Neoplasms Aged Retrospective Studies Aged 80 and over Bladder cancer business.industry Perioperative medicine.disease Surgery Peritoneal carcinomatosis medicine.anatomical_structure Urinary Bladder Neoplasms Lymphatic Metastasis 030220 oncology & carcinogenesis Female Neoplasm Recurrence Local business |
| Zdroj: | Journal of Urology. 196:1390-1396 |
| ISSN: | 1527-3792 0022-5347 |
| DOI: | 10.1016/j.juro.2016.05.101 |
| Popis: | Peritoneal carcinomatosis and extrapelvic lymph node metastases can be seen following robot-assisted radical cystectomy. In an attempt to identify predictors of these atypical metastases we report a detailed analysis of patients treated with robot-assisted radical cystectomy in whom recurrences developed.A total of 310 patients underwent robot-assisted radical cystectomy for bladder cancer from 2001 to 2015. Descriptive statistics were used to compare baseline variables between patients without recurrence and those with local, distant or atypical recurrence. Univariate and multivariable regression models were used to assess the effect of variables on oncologic outcomes including recurrence location.At a median followup of 24 months (IQR 14-51) 81 patients had recurrence. On multivariable analysis tumor classification, lymphovascular invasion, estimated glomerular filtration rate less than 60 ml/minute/1.73 mPredictors of distant recurrences, peritoneal carcinomatosis and extrapelvic lymph node metastases after robot-assisted radical cystectomy did not significantly differ and were mainly dictated by pathological tumor characteristics. Results suggest that the risk of atypical recurrence is chiefly influenced by tumor biology rather than surgical aspects. |
| Databáze: | OpenAIRE |
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