MP49-12: Recurrences after Robot-Assisted Radical Cystectomy: Results from the International Robotic Cystectomy Consortium
Friday, May 15, 2020
7:00 AM – 9:00 AM
Ahmed Elsayed, Sean Gibson, Zhe Jing, Jennifer Osei, Lee Richstone, Andrew Wagner, Bertram Yuh, Juan Palou, Ahmed Aboumohamed, Eric Kim, Hannah Kiss, Morgan Roupret, Ketan Badani, Derya Balbay, Carl Wijburg, John Kelly, Koon Rha, Franco Gaboardi, Michael Stöckle, Prokar Dasgupta, Shamim Khan, Ashok Hemal, Peter Wiklund, Jihad Kaouk, James Peabody, Mani Menon, Ahmed Hussein, Khurshid Guru
Introduction: There have been concerns about higher incidence of local recurrence after robot-assisted radical cystectomy (RARC) compared to its open counterpart. We sought to report and detail recurrences following RARC utilizing a multinational database.
Methods: A retrospective review of the International Robotic Cystectomy Consortium (IRCC) database was performed (3296 patients, 28 institutions, from 14 countries). Data were reviewed for demographics, perioperative, pathologic and oncologic outcomes. Recurrence rates and patterns were analyzed. Kaplan Meier curves were used to depict recurrence-free (RFS), local recurrence-free (LRFS), and distant recurrence-free survival (DRFS). Multivariate stepwise Cox regression models were used to identify variables associated with RFS, LRFS, and DRFS.
Results: Out of 1976 patients with complete data, 498 (25%) relapsed. Mean age was 68±11 years, with a median follow up of 26 months. Distant recurrences were observed in 18% of patients and local recurrences in 12%. Early oncologic failure (within 3 month) occurred in 7%. Port site recurrence occurred in one patient and peritoneal carcinomatosis in 23 patients (1%). The most common sites of local and distant recurrence were the pelvis and lungs, respectively (Table 1a). The 5-year RFS, LRFS, and DRFS were 65%, 83%, and 74%, respectively (Figure 1). Multivariate regression models identified pN+ status and =pT3 as predictors of RFS, LRFS and DRFS (p<0.01) (Table 1b).
Conclusions: Recurrence patterns and rates after RARC seem comparable to open series. Disease stage remains the main predictor of recurrence following RC. Source of
