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Laparoscopic radical cystectomy for cancer: oncological outcomes at up to 5 years
Author(s) -
Haber GeorgesPascal,
Gill Inderbir S.
Publication year - 2007
Publication title -
bju international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.773
H-Index - 148
eISSN - 1464-410X
pISSN - 1464-4096
DOI - 10.1111/j.1464-410x.2007.06865.x
Subject(s) - medicine , cystectomy , bladder cancer , lymphadenectomy , urinary diversion , stage (stratigraphy) , cancer , lymphovascular invasion , cancer registry , surgery , general surgery , metastasis , paleontology , biology
Associate Editor Ash Tewari Editorial Board Ralph Clayman, USA Inderbir Gill, USA Roger Kirby, UK Mani Menon, USA OBJECTIVE To report the oncological outcomes at ≤ 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. PATIENTS AND 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 (≥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 ≥ 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. CONCLUSION To our knowledge, this is the first report of ≤ 5‐year follow‐up after LRC; the data suggest that LRC provides oncological outcomes comparable to contemporary series of open RC.