Department of Urology APHP, CHU Henri Mondor, U955 E907 Créteil, France. Department of Pathology APHP, CHO Henri Mondor, U955 E907 Créteil, France.
Study Type - Therapy (case series) Level of Evidence 4.
To assess the mid-term (3 years of follow-up) oncological control of laparoscopic radical cystectomy (LRC) for high-grade muscle-invasive bladder cancer in a well studied male population.
We assessed 40 men with bladder cancer (mean [range] age 66.5 [50-75] years) who underwent LRC and extended pelvic lymphadenectomy at our institution between April 2004 and September 2008. Of the 40 patients, 13 (32.5%) had a complete laparoscopic procedure (ileal conduit: seven patients; neobladder: five patients; bilateral ureterostomy: one patient) and 27 (67.5%) had an LRC procedure only (ileal conduit: 15 patients; neobladder: 12 patients).
No major complications were observed intraoperatively. The mean operating time was 407 min and the mean blood loss was 720 mL. Four patients (10%) required conversion to open surgery. The mean (range) hospital stay was 10.2 (7-25) days. One patient died of myocardial infarction in the postoperative period. Pathological analysis showed organ-confined tumours (stage pT0/pT1/pT2/pT3a) in 22 patients (55%) and extravesical disease (pT3/pT4) in 18 (45%). Of the 40 patients, six (15%) had lymph node involvement. The mean (range) number of nodes removed was 19.9 (5-40). At a mean (range) follow-up period of 36 (0-72) months, 26 patients were alive with no evidence of disease (disease-free survival rate 67%).
Laparoscopic radical cystectomy is a safe, feasible, and effective alternative to open radical cystectomy (ORC). The 3-year oncological efficacy was comparable with that of ORC.
Written by:
Gillion N, Xylinas E, Durand X, Ploussard G, Vordos D, Allory Y, Hoznek A, de la Taille A, Abbou CC, Salomon L.
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Reference: BJU Int. 2011 Feb 14. Epub ahead of print.
doi: 10.1111/j.1464-410X.2010.10054.x
PubMed Abstract
PMID: 21320272
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