Oncologic outcomes and predictive factors for recurrence following robot-assisted radical cystectomy for urothelial carcinoma

Multicenter study from Korea

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

Research output: Contribution to journalArticle

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.

Original languageEnglish
Pages (from-to)1662-1668
Number of pages7
JournalJournal of Korean Medical Science
Volume32
Issue number10
DOIs
Publication statusPublished - 2017 Oct 1

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Cystectomy
Korea
Multicenter Studies
Carcinoma
Recurrence
Lymph Node Excision
Survival
Logistic Models
Lymph Nodes
Neoplasms
Kaplan-Meier Estimate
Tertiary Care Centers
Urinary Bladder
Regression Analysis
Demography

Keywords

  • Bladder cancer
  • Outcomes
  • Radical cystectomy
  • Recurrence
  • Urothelial carcinoma

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Oncologic outcomes and predictive factors for recurrence following robot-assisted radical cystectomy for urothelial carcinoma : Multicenter study from Korea. / Shim, Ji Sung; Kwon, Tae Gyun; Rha, Koon Ho; Lee, Young Goo; Lee, Ji Youl; Jeong, Byong Chang; Kim, Jae Yoon; Pyun, Jong Hyun; Kang, Sung-Gu; Kang, Seok Ho.

In: Journal of Korean Medical Science, Vol. 32, No. 10, 01.10.2017, p. 1662-1668.

Research output: Contribution to journalArticle

Shim, Ji Sung ; Kwon, Tae Gyun ; Rha, Koon Ho ; Lee, Young Goo ; Lee, Ji Youl ; Jeong, Byong Chang ; Kim, Jae Yoon ; Pyun, Jong Hyun ; Kang, Sung-Gu ; Kang, Seok Ho. / Oncologic outcomes and predictive factors for recurrence following robot-assisted radical cystectomy for urothelial carcinoma : Multicenter study from Korea. In: Journal of Korean Medical Science. 2017 ; Vol. 32, No. 10. pp. 1662-1668.
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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.",
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AU - Rha, Koon Ho

AU - Lee, Young Goo

AU - Lee, Ji Youl

AU - Jeong, Byong Chang

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