Perioperative and survival outcomes of patients with a history of pelvic radiation undergoing salvage robot-assisted radical cystectomy. An rrc-icud collaborative study

You have accessJournal of UrologyCME1 Apr 2023MP56-13 PERIOPERATIVE AND SURVIVAL OUTCOMES OF PATIENTS WITH A HISTORY OF PELVIC RADIATION UNDERGOING SALVAGE ROBOT-ASSISTED RADICAL CYSTECTOMY. AN RRC-ICUD COLLABORATIVE STUDY Giovanni Cacciamani, Joge Ballon, Viktor Skokic, Gus Miranda, John Sfakianos, Etienne Lavallee, Yuan Shuo Wang, Linda Dey, Arad Hosseini, Juhana Rautiola, Gunnar Steineck, Monish Aron, Inderbir Gill, Abolfazl Hosseini, Reza Mehrazin, Peter Wiklund, and Mihir Desai Giovanni CacciamaniGiovanni Cacciamani More articles by this author , Joge BallonJoge Ballon More articles by this author , Viktor SkokicViktor Skokic More articles by this author , Gus MirandaGus Miranda More articles by this author , John SfakianosJohn Sfakianos More articles by this author , Etienne LavalleeEtienne Lavallee More articles by this author , Yuan Shuo WangYuan Shuo Wang More articles by this author , Linda DeyLinda Dey More articles by this author , Arad HosseiniArad Hosseini More articles by this author , Juhana RautiolaJuhana Rautiola More articles by this author , Gunnar SteineckGunnar Steineck More articles by this author , Monish AronMonish Aron More articles by this author , Inderbir GillInderbir Gill More articles by this author , Abolfazl HosseiniAbolfazl Hosseini More articles by this author , Reza MehrazinReza Mehrazin More articles by this author , Peter WiklundPeter Wiklund More articles by this author , and Mihir DesaiMihir Desai More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003309.13AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: There are lack of data on salvage robot-assisted radical cystectomy (sRRC) after pelvic radiation therapy (RT) in patients with bladder cancer. We present perioperative, oncological, and long terms survival outcomes for patients with a history of pelvic radiation who had undergone sRRC from 3 high-volume centers. METHODS: Data from prospectively maintained databases from 3 centers (USC, Karolinska Institute, Mount Sinai) from 2009-2019 were retrospectively reviewed. Patients with a history of pelvic radiation who underwent sRRC with Intracorporeal (ICUD) or extracorporeal (ECUD) for intent to cure bladder cancer were identified. Using a propensity score estimation (based on age, BMI, gender, ASA score, neoadjuvant chemotherapy, and clinical tumor stage (Caliper size 0.2), patients were matched 1:1 to a cohort undergoing RRC without prior history of pelvic radiation. Both groups were compared for perioperative, oncologic, and survival outcomes with up to 3 years of follow-up. RESULTS: A total of 92 sRRC were PS matched to 92 patients undergoing RRC. While both groups were similar in the proportion of ICUD (70.3 vs 78.3%, p=0.29), the sRRC had a lower proportion of continent diversion (6.7 vs 22.8%, p=0.004)). There were no significant differences between the 2 groups in operative time (333.8 vs 348.2 minutes, p=0.246), postoperative complications, at 30 days (p=0.36), and 31-90 days (p=0.64), and readmission rates at 30 days (16.3 vs 19.6%, p=0.70) and 31-90 days (16.5 vs 21.8%, p=0.48). The sRRC group had a lower number of lymph nodes (LNDs) retrieved (20.1 vs 29, p≤0.001), positive LNDs (0.3 vs 1.7, p=0.007), and positive LNDs rate (0.03 vs 0.07%, p=0.035). However no significant differences observed in tumor stage (p=0.41) and LNDs stage (p=0.065) and rate (23.9 vs 29.3; p=0.5). At 3 years, OSS (59.1 vs 67.8% p=0.27), CSS (74.9 vs 74.4% p=0.59), and RFS (70.7 vs 76.1 p=0.67) were similar between sRRC and RRC. CONCLUSIONS: This largest multi-institutional contemporary study provides the best evidence to date supporting the feasibility of sRRC. Perioperative and survival outcomes were comparable between the two groups indicating that sRRC is feasible for selected patients who have underwent pelvic RT. Source of Funding: none © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e779 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Giovanni Cacciamani More articles by this author Joge Ballon More articles by this author Viktor Skokic More articles by this author Gus Miranda More articles by this author John Sfakianos More articles by this author Etienne Lavallee More articles by this author Yuan Shuo Wang More articles by this author Linda Dey More articles by this author Arad Hosseini More articles by this author Juhana Rautiola More articles by this author Gunnar Steineck More articles by this author Monish Aron More articles by this author Inderbir Gill More articles by this author Abolfazl Hosseini More articles by this author Reza Mehrazin More articles by this author Peter Wiklund More articles by this author Mihir Desai More articles by this author Expand All Advertisement PDF downloadLoading ...