title: Mid-term oncological control after laparoscopic radical cystectomy in men: a single-centre experience.
abstract: OBJECTIVE
  • To assess the mid-term (3 years of follow-up) oncological control of laparoscopic radical cystectomy (LRC) for high-grade muscle-invasive bladder cancer in a well studied male population.
  
  
  METHODS
  • We assessed 40 men with bladder cancer (mean [range] age 66.5 [50-75] years) who underwent LRC and extended pelvic lymphadenectomy at our institution between April 2004 and September 2008. • Of the 40 patients, 13 (32.5%) had a complete laparoscopic procedure (ileal conduit: seven patients; neobladder: five patients; bilateral ureterostomy: one patient) and 27 (67.5%) had an LRC procedure only (ileal conduit: 15 patients; neobladder: 12 patients).
  
  
  RESULTS
  • No major complications were observed intraoperatively. • The mean operating time was 407 min and the mean blood loss was 720 mL. Four patients (10%) required conversion to open surgery. The mean (range) hospital stay was 10.2 (7-25) days. One patient died of myocardial infarction in the postoperative period. • Pathological analysis showed organ-confined tumours (stage pT0/pT1/pT2/pT3a) in 22 patients (55%) and extravesical disease (pT3/pT4) in 18 (45%). Of the 40 patients, six (15%) had lymph node involvement. The mean (range) number of nodes removed was 19.9 (5-40). • At a mean (range) follow-up period of 36 (0-72) months, 26 patients were alive with no evidence of disease (disease-free survival rate 67%).
  
  
  CONCLUSIONS
  • Laparoscopic radical cystectomy is a safe, feasible, and effective alternative to open radical cystectomy (ORC). The 3-year oncological efficacy was comparable with that of ORC.
authors.affiliation: Department of Urology APHP, CHU Henri Mondor, U955 E907 Créteil, France.
authors.forename: Norman
authors.initials: N
authors.lastname: Gillion
authors.forename: Evanguelos
authors.initials: E
authors.lastname: Xylinas
authors.forename: Xavier
authors.initials: X
authors.lastname: Durand
authors.forename: Guillaume
authors.initials: G
authors.lastname: Ploussard
authors.forename: Dimitri
authors.initials: D
authors.lastname: Vordos
authors.forename: Yves
authors.initials: Y
authors.lastname: Allory
authors.forename: Andras
authors.initials: A
authors.lastname: Hoznek
authors.forename: Alexandre
authors.initials: A
authors.lastname: de la Taille
authors.forename: Claude Clément
authors.initials: CC
authors.lastname: Abbou
authors.forename: Laurent
authors.initials: L
authors.lastname: Salomon
mesh_terms: D000368:Aged; D002295:Carcinoma, Transitional Cell / Q000601:surgery*; D015653:Cystectomy / Q000379:methods*; D005500:Follow-Up Studies; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013997:Time Factors; D001749:Urinary Bladder Neoplasms / Q000601:surgery*