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Oncologic Outcomes and Predictive Factors for Recurrence Following Robot-Assisted Radical Cystectomy for Urothelial Carcinoma: Multicenter Study from Korea

Authors
 Ji Sung Shim  ;  Tae Gyun Kwon  ;  Koon Ho Rha  ;  Young Goo Lee  ;  Ji Youl Lee  ;  Byong Chang Jeong  ;  Jae Yoon Kim  ;  Jong Hyun Pyun  ;  Sung Gu Kang  ;  Seok Ho Kang 
Citation
 JOURNAL OF KOREAN MEDICAL SCIENCE, Vol.32(10) : 1662-1668, 2017 
Journal Title
 JOURNAL OF KOREAN MEDICAL SCIENCE 
ISSN
 1011-8934 
Issue Date
2017
MeSH
Aged ; Carcinoma, Transitional Cell/mortality ; Carcinoma, Transitional Cell/pathology* ; Carcinoma, Transitional Cell/surgery ; Cystectomy ; Disease-Free Survival ; Female ; Humans ; Kaplan-Meier Estimate ; Logistic Models ; Lymph Node Excision ; Male ; Middle Aged ; Neoplasm Metastasis ; Neoplasm Recurrence, Local ; Neoplasm Staging ; Odds Ratio ; Republic of Korea ; Robotic Surgical Procedures/methods* ; Tertiary Care Centers ; Treatment Outcome ; Urinary Bladder Neoplasms/mortality ; Urinary Bladder Neoplasms/pathology* ; Urinary Bladder Neoplasms/surgery
Keywords
Bladder Cancer ; Outcomes ; Radical Cystectomy ; Recurrence ; Urothelial Carcinoma
Abstract
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.
Files in This Item:
T201704824.pdf Download
DOI
10.3346/jkms.2017.32.10.1662
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Urology (비뇨의학교실) > 1. Journal Papers
Yonsei Authors
Rha, Koon Ho(나군호) ORCID logo https://orcid.org/0000-0001-8588-7584
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/161451
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