Early Recurrence Patterns Following Totally Intracorporeal Robot-assisted Radical Cystectomy: Results from the EAU Robotic Urology Section (ERUS) Scientific Working Group.
Recurrence following radical cystectomy often occurs early, with >80% of recurrences occurring within the first 2 yr. Debate remains as to whether robot-assisted radical cystectomy (RARC) negatively impacts early recurrence patterns because of inadequate resection or pneumoperitoneum. We report early recurrence patterns among 717 patients who underwent RARC with intracorporeal urinary diversion at nine different institutions with a minimum follow-up of 12 mo. Clinical, pathologic, radiologic, and survival data at the latest follow-up were collected. Recurrence-free survival (RFS) estimates were generated using the Kaplan-Meier method, and Cox regression models were built to assess variables associated with recurrence. RFS at 3, 12, and 24 mo was 95.9%, 80.2%, and 74.6% respectively. Distant recurrences most frequently occurred in the bones, lungs, and liver, and pelvic lymph nodes were the commonest site of local recurrence. We identified five patients (0.7%) with peritoneal carcinomatosis and two patients (0.3%) with metastasis at the port site (wound site). We conclude that unusual recurrence patterns were not identified in this multi-institutional series and that recurrence patterns appear similar to those in open radical cystectomy series.



In this multi-institutional study, bladder cancer recurrences following robotic surgery are described. Early recurrence rates and locations appear to be similar to those for open radical cystectomy series.
Karolinska University Hospital, Stockholm, Sweden.
Justin W
JW
Collins
Karolinska University Hospital, Stockholm, Sweden.
Abolfazl
A
Hosseini
Karolinska University Hospital, Stockholm, Sweden.
Christofer
C
Adding
Karolinska Institute, Stockholm, Sweden.
Tommy
T
Nyberg
Bristol Urological Institution, Bristol, UK.
Anthony
A
Koupparis
Bristol Urological Institution, Bristol, UK.
Edward
E
Rowe
St. Georges Hospital London, London, UK.
Matthew
M
Perry
St. Georges Hospital London, London, UK.
Rami
R
Issa
Hirslanden Klinik, Aarau, Switzerland.
Martin C
MC
Schumacher
Carl Wijburg, Rijnstate, Arnhem, The Netherlands.
Carl
C
Wijburg
Ankara Ataturk Hospital, Ankara, Turkey.
Abdullah E
AE
Canda
Memorial Sisli Hospital, Istanbul, Turkey.
Mevlana
M
Balbay
Ghent University Hospital, Ghent, Belgium.
Karel
K
Decaestecker
University of Tübingen, Tübingen, Germany.
Christian
C
Schwentner
University of Tübingen, Tübingen, Germany.
Arnulf
A
Stenzl
Da Vinci Zentrum, Hanover, Germany.
Sebastian
S
Edeling
Da Vinci Zentrum, Hanover, Germany.
Saša
S
Pokupić
O.L.V, Clinic, Aalst, Belgium.
Fredrik
F
D'Hondt
O.L.V, Clinic, Aalst, Belgium.
Alexander
A
Mottrie
Karolinska University Hospital, Stockholm, Sweden. Electronic address: peter.wiklund@karolinska.se.
Peter N
PN
Wiklund
D000368:Aged; D001859:Bone Neoplasms / Q000453:epidemiology* / Q000556:secondary; D002295:Carcinoma, Transitional Cell / Q000556:secondary / Q000601:surgery*; D015653:Cystectomy / Q000379:methods*; D018572:Disease-Free Survival; D005060:Europe; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D008113:Liver Neoplasms / Q000453:epidemiology* / Q000556:secondary; D008175:Lung Neoplasms / Q000453:epidemiology* / Q000556:secondary; D008198:Lymph Nodes / Q000473:pathology; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology*; D010388:Pelvis; D010534:Peritoneal Neoplasms / Q000453:epidemiology / Q000556:secondary; D016016:Proportional Hazards Models; D065287:Robotic Surgical Procedures / Q000379:methods*; D012955:Societies, Medical; D001749:Urinary Bladder Neoplasms / Q000473:pathology / Q000601:surgery*; D014547:Urinary Diversion / Q000379:methods*; D014572:Urology
Early recurrence patterns; Oncologic outcomes; Robot-assisted radical cystectomy; Totally intracorporeal robot-assisted radical cystectomy