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A comparative population-based analysis of peritoneal carcinomatosis in patients undergoing robotic-assisted and open radical cystectomy

  • Urology - Original Paper
  • Published:
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Abstract

Purpose

To compare the population-based incidence of peritoneal carcinomatosis following open (ORC) vs. robotic-assisted radical cystectomy (RARC).

Methods

Using the Surveillance, Epidemiology and End Results Program (SEER)—Medicare linked data, we identified 1,621 patients who underwent radical cystectomy for bladder cancer during 2009 and 2014; 18.1% (n = 294) and 81.9% (n = 1327) underwent RARC and ORC, respectively. We subsequently evaluated the rates of peritoneal carcinomatosis at 6, 12, and 24 months following surgery. Multivariable proportional hazards regression was performed to determine factors associated with development of peritoneal carcinomatosis.

Results

Patients who underwent RARC vs. ORC were more likely to be male (p = 0.04); however, age at diagnosis, race, comorbidities, education, and marital status (all p > 0.05) did not differ by surgical approaches. Our findings showed that there were no significant differences in the rates of peritoneal carcinomatosis between ORC and RARC at 6, 12, and 24 months. In adjusted analyses, factors associated with peritoneal carcinomatosis were advanced N stage (N0 versus N2/3: HR 0.30, 95% CI 0.16–0.55, p < 0.01), preoperative hydronephrosis (HR 1.70, 95% CI 1.09–2.65, p = 0.04), higher T stage (T1 versus T4: HR 0.34, 95% CI 0.15–0.79, p < 0.01; T2 versus T4: HR 0.39, 95% CI 0.20–0.76, p < 0.01), and use of neoadjuvant chemotherapy (HR 1.78, 95% CI 1.11–2.84, p < 0.01). However, RARC was not associated with peritoneal carcinomatosis (HR 1.36, 95% CI 0.78–2.35).

Conclusion

In this population-based analysis, we found no difference in peritoneal carcinomatosis between robotic or open approaches to radical cystectomy. These data should be reassuring to those utilizing robotic cystectomy.

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References

  1. Witjes JA, Compérat E, Cowan NC, De Santis M, Gakis G, Lebret T, Ribal MJ, Van der Heijden AG, Sherif A (2014) EAU guidelines on muscle-invasive and metastatic bladder cancer: summary of the 2013 guidelines. Eur Urol 65(4):778–792

    Article  Google Scholar 

  2. Menon M, Hemal AK, Tewari A, Shrivastava A, Shoma AM, El-Tabey NA et al (2003) Nerve-sparing robot-assisted radical cystoprostatectomy and urinary diversion. BJU Int 92:232–236

    Article  CAS  Google Scholar 

  3. Leow JJ, Reese SW, Jiang W, Lipsitz SR, Bellmunt J, Trinh QD et al (2014) Propensity-matched comparison of morbidity and costs of open and robot-assisted radical cystectomies: a contemporary population-based analysis in the United States. Eur Urol 66:569–576

    Article  Google Scholar 

  4. Yu HY, Hevelone ND, Lipsitz SR, Kowalczyk KJ, Nguyen PL, Choueiri TK et al (2012) Comparative analysis of outcomes and costs following open radical cystectomy versus robot-assisted laparoscopic radical cystectomy: results from the US Nationwide Inpatient Sample. Eur Urol 61:1239–1244

    Article  Google Scholar 

  5. Bochner BH, Dalbagni G, Marzouk KH, Sjoberg DD, Lee J, Donat SM et al (2018) Randomized trial comparing open radical cystectomy and robot-assisted laparoscopic radical cystectomy: oncologic outcomes. Eur Urol 74:465–471

    Article  Google Scholar 

  6. Hanna N, Leow JJ, Sun M, Friedlander DF, Seisen T, Abdollah F et al (2018) Comparative effectiveness of robot-assisted vs. open radical cystectomy. Urol Oncol 36:88

    Article  Google Scholar 

  7. Hussein AA, Saar M, May PR, Wijburg CJ, Richstone L, Wagner A et al (2017) Early oncologic failure after robot-assisted radical cystectomy: results from the international robotic cystectomy consortium. J Urol 197:1427–1436

    Article  Google Scholar 

  8. Venkatramani V, Reis IM, Castle EP, Gonzalgo ML, Woods ME, Svatek RS et al (2020) Predictors of recurrence, and progression-free and overall survival following open versus robotic radical cystectomy: analysis from the RAZOR trial with a 3-year followup. J Urol 203:522–529

    Article  Google Scholar 

  9. Ramirez PT, Frumovitz M, Pareja R, Lopez A, Vieira M, Ribeiro R et al (2018) Minimally invasive versus abdominal radical hysterectomy for cervical cancer. N Engl J Med 379:1895–1904

    Article  Google Scholar 

  10. Nguyen DP, Al Hussein Al Awamlh B, Wu X, O’Malley P, Inoyatov IM, Ayangbesan A et al (2015) Recurrence patterns after open and robot-assisted radical cystectomy for bladder cancer. Eur Urol 68:399–405

    Article  Google Scholar 

  11. Audenet F, Sfakianos JP (2017) Evidence of atypical recurrences after robot-assisted radical cystectomy: a comprehensive review of the literature. Bladder Cancer 3:231–236

    Article  Google Scholar 

  12. Williams SB, Kamat AM, Lamm DL (2015) Pelvic recurrence after radical cystectomy: a call to arms. BJU Int 116:172–173

    Article  Google Scholar 

  13. Yang DY, Frank I, Avant RA, Miller AR, Thapa P, Boorjian SA et al (2019) Incidence and risk factors for peritoneal carcinomatosis following open radical cystectomy. Urol Oncol 37:886–892

    Article  Google Scholar 

  14. Elsayed AS, Gibson S, Jing Z, Wijburg C, Wagner AA, Mottrie A et al (2020) Rates and patterns of recurrences, and survival outcomes after robot-assisted radical cystectomy: results from the international robotic cystectomy consortium. J Urol. https://doi.org/10.1097/JU0000000000001380

    Article  PubMed  Google Scholar 

  15. Warren JL, Klabunde CN, Schrag D, Bach PB, Riley GF (2002) Overview of the SEER-Medicare data: content, research applications, and generalizability to the United States elderly population. Med Care. https://doi.org/10.1097/00005650-200208001-00002

    Article  PubMed  Google Scholar 

  16. Elixhauser A, Steiner C, Harris DR, Coffey RM (1998) Comorbidity measures for use with administrative data. Med Care 36:8–27

    Article  CAS  Google Scholar 

  17. Goh AC, Belarmino A, Patel NA, Sun T, Sedrakyan A, Bochner BH et al (2020) A population-based study of ureteroenteric strictures after open and robot-assisted radical cystectomy. Urology 135:57–65

    Article  Google Scholar 

  18. Nguyen DP, Al Hussein Al Awamlh B, O’Malley P, Khan F, Lewicki PJ, Golombos DM et al (2016) Factors impacting the occurrence of local, distant and atypical recurrences after robot-assisted radical cystectomy: a detailed analysis of 310 patients. J Urol 196:1390–1396

    Article  Google Scholar 

  19. Bartsch GC, Kuefer R, Gschwend JE, de Petriconi R, Hautmann RE, Volkmer BG (2007) Hydronephrosis as a prognostic marker in bladder cancer in a cystectomy-only series. Eur Urol 51:690–697

    Article  Google Scholar 

  20. Ost MC, Patel KP, Rastinehad AR, Chu PY, Anderson AE, Smith AD et al (2008) Pneumoperitoneum with carbon dioxide inhibits macrophage tumor necrosis factor-alpha secretion: source of transitional-cell carcinoma port-site metastasis, with prophylactic irrigation strategies to decrease laparoscopic oncologic risks. J Endourol 22:105–112

    Article  Google Scholar 

  21. Jacobi CA, Wenger FA, Ordemann J, Gutt C, Sabat R, Muller JM (1998) Experimental study of the effect of intra-abdominal pressure during laparoscopy on tumour growth and port site metastasis. Br J Surg 85:1419–1422

    Article  CAS  Google Scholar 

  22. Kazemier G, Bonjer HJ, Berends FJ, Lange JF (1995) Port site metastases after laparoscopic colorectal surgery for cure of malignancy. Br J Surg 82:1141–1142

    Article  CAS  Google Scholar 

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Funding

Jim C. Hu and Leonardo D. Borregales receives research support from the Frederick J. and Theresa Dow Wallace Fund of the New York Community Trust. Jim C. Hu also receives salary support from NIH R01 CA241758 and PCORI CER-2019C1-15682. Jonathan E. Shoag is supported by the Damon Runyon Cancer Research Foundation Physician Scientist Training Award and Vinney Scholar Award.

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Authors and Affiliations

  1. Department of Urology, NewYork-Presbyterian Hospital, Weill Cornell Medicine, 525 East 68th Street, Starr 900, New York, NY, 10021, USA

    Spyridon P. Basourakos, Bashir Al Hussein Al Awamlh, Leonardo D. Borregales, Parwiz Abrahimi, Jonathan E. Shoag & Jim C. Hu

  2. Department of Health Policy, Weill Cornell Medicine, New York, NY, USA

    Art Sedrakyan

  3. Department of Urology, Case Western Reserve University School of Medicine, University Hospitals Cleveland Medical Center, Cleveland, OH, USA

    Jonathan E. Shoag

Authors
  1. Spyridon P. Basourakos
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  2. Bashir Al Hussein Al Awamlh
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  3. Leonardo D. Borregales
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  4. Parwiz Abrahimi
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  5. Art Sedrakyan
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  6. Jonathan E. Shoag
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  7. Jim C. Hu
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Contributions

SPB: project development, data collection, data analysis, and manuscript writing. BAHAA: project development, data collection, data analysis, and manuscript writing. LDB: manuscript writing/editing. PA: manuscript writing/editing. AS: protocol/project development and manuscript writing/editing. JES: protocol/project development and manuscript writing/editing. JCH: protocol/project development and manuscript writing/editing.

Corresponding author

Correspondence to Jim C. Hu.

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Conflict of interest

The authors declare no conflicts of interest.

Research involving human participants and/or animals

SEER-Medicare data are considered by HIPAA requirements as a limited data set, which requires that investigators sign a Data Use Agreement prior to receiving the data. This exception allows for the release of the SEER-Medicare data without obtaining authorization from individual patients (see Federal Register, August 14, 2002, pg 53235).

Informed consent

Our study was approved by the Weill Cornell Medicine Institutional Review Board. Medicare files used were in accordance with data agreement between National Cancer Institute (NCI) and the Centers for Medicare and Medicaid Services (CMMS).

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Basourakos, S.P., Al Hussein Al Awamlh, B., Borregales, L.D. et al. A comparative population-based analysis of peritoneal carcinomatosis in patients undergoing robotic-assisted and open radical cystectomy. Int Urol Nephrol 54, 1513–1519 (2022). https://doi.org/10.1007/s11255-022-03216-2

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  • DOI: https://doi.org/10.1007/s11255-022-03216-2

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