Robotic Radical Cystectomy Outcomes after Intervention for Prostate Cancer.

Journal: Journal of endourology
Published Date: May 1, 2021

Abstract

We evaluated patients who underwent treatment for prostate cancer and then subsequent robot-assisted radical cystectomy (RARC). Our objective was to understand clinical, pathologic, and survival outcomes in these patients. A total of 333 male patients underwent RARC with standard intracorporeal urinary diversion from 2009 to 2019. We evaluated patients who underwent a radical prostatectomy (RP) and either external beam radiation or brachytherapy (XRT) before RARC. These patients were compared with patients who underwent RARC without any prior intervention for or history of prostate cancer (radical cystectomy [RC]). Patients in the RP and XRT groups were found to be older than the RC group ( = 0.0108) and also have a greater Charlson comorbidity index ( < 0.001). There was no difference in estimated blood loss, operative time, and length of stay across all three groups. The RP group had a higher rate of positive margins 31.58% compared with RC and XRT at 8.22% and 10.00%, respectively ( = 0.0036). There was also a higher rate of extravesical disease on final pathology report for the XRT group at 60.00% compared with 37.5% and 36.85% for RC and RP, respectively ( = 0.0056). Overall survival was lowest in the XRT group compared with RP and RC ( > 0.001) with no difference in recurrence-free survival. Patients in the RP group have higher rates of positive margin, whereas patients in the XRT group have higher rates of extravesical disease and overall survival after undergoing a RARC. Careful counseling and attention to these parameters is required in these patient populations.

Authors

  • Neel H Patel
    Department of Urology, University of Southern California, Los Angeles, California, USA.
  • Gus Miranda
    USC Institute of Urology, Keck School of Medicine, University of Southern California, Health Sciences Campus, Los Angeles, CA, United States of America.
  • Jie Cai
    Research Center for Drug Discovery, School of Pharmaceutical Sciences, Sun Yat-Sen University, 132 East Circle at University City, Guangzhou, 510006, China.
  • Mihir Desai
    Catherine and Joseph Aresty Department of Urology, USC Institute of Urology, Keck School of Medicine/Norris Cancer Center, University of Southern California, Los Angeles, CA, USA.
  • Inderbill Gill
    Department of Urology, University of Southern California, Los Angeles, California, USA.
  • Monish Aron
    USC Institute of Urology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA. Electronic address: monisharon@hotmail.com.

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