Laparoscopic radical cystectomy for cancer: oncological outcomes at up to 5 years.
OBJECTIVE
To report the oncological outcomes at < or = 5 years after laparoscopic radical cystectomy (LRC), as open RC is the reference standard treatment for muscle-invasive bladder cancer, but interest in LRC is increasing at selected centres worldwide and as yet there are no long-term follow-up data.


METHODS
Between December 1999 and January 2005, 37 patients (mean age 66 years) had LRC with urinary diversion for invasive bladder cancer; 26 patients (70%) also had an extended pelvic lymphadenectomy. Overall and cancer-specific survival data were obtained from patient charts, radiographic reports, telephone contact, and a check of the Social Security Death Index.


RESULTS
Most tumours were transitional cell carcinoma (32, 86%), high-grade (grade III in 29, 78%) and high-stage (> or =pT2 in 26, 70%). Two patients had a positive surgical margin. The median (range) number of lymph nodes excised was 14 (2-24); seven patients (17%) had node-positive disease (pN1). Follow-up data were available for 35 patients (95%); eight (22%) completed > or = 5 years of follow-up, and the mean (range) follow-up was 31 (1-66) months. At the last follow-up, 24 patients (65%) were alive with no evidence of disease and 11 (30%) were dead, two (5%) from metastasis and nine (24%) from unrelated causes. The 5-year actuarial overall, cancer-specific and recurrence-free survival was 63%, 92% and 92%, respectively.


CONCLUSIONS
To our knowledge, this is the first report of < or = 5-year follow-up after LRC; the data suggest that LRC provides oncological outcomes comparable to contemporary series of open RC.
Haber
Georges-Pascal
GP
Section of Laparoscopic and Robotic Surgery, Glickman Urological Institute, The Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, OH 44195, USA.
Gill
Inderbir S
IS
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002295:Carcinoma, Transitional Cell / Q000401:mortality / Q000601:surgery*; D015653:Cystectomy / Q000379:methods*; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D010535:Laparoscopy / Q000379:methods; D008197:Lymph Node Excision / Q000379:methods; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009362:Neoplasm Metastasis; D009364:Neoplasm Recurrence, Local / Q000401:mortality; D016019:Survival Analysis; D013997:Time Factors; D016896:Treatment Outcome; D001749:Urinary Bladder Neoplasms / Q000401:mortality / Q000601:surgery*; D014547:Urinary Diversion / Q000379:methods*