Abstract
Radical cystectomy with pelvic lymphadenectomy remains the standard treatment for muscle-invasive bladder cancer. However, bladder preservation with radiotherapy, with or without chemotherapy, represents an alternative treatment strategy. In patients that fail this bladder conservation treatment, salvage cystectomy is then indicated to treat persistent or recurrent cancer. We report our experience with robotic-assisted laparoscopic salvage radical cystoprostatectomy with pelvic lymph node dissection in a 91-year-old man. This minimally invasive approach for treatment of persistent bladder cancer refractory to chemoradiation, even in the nonagenarian, is a safe and viable alternative to traditional open surgery.
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References
American Cancer Society (2008) Cancer facts & figures 2008. American Cancer Society, Atlanta, GA
Stein JP, Lieskovsky G, Cote R, Groshen S, Feng AC, Boyd S, Skinner E, Bochner B, Thangathurai D, Mikhail M, Raghavan D, Skinner DG (2001) Radical cystectomy in the treatment of invasive bladder cancer: long-term results in 1,054 patients. J Clin Oncol 19:666–675
Nieh PT, Marshall FF (2006) Surgery of bladder cancer. In: Wein AJ, Kavoussi LR, Novick AC, Partin AW, Peters CA (eds) Campbell-Walsh urology, 9th edn. Saunders, Philadelphia, PA, pp 2479–2506
Borgaonkar S, Jain A, Bollina P, McLaren DB, Tulloch D, Kerr GR, Howard GC (2002) Radical radiotherapy and salvage cystectomy as the primary management of transitional cell carcinoma of the bladder. Results following the introduction of a CT planning technique. Clin Oncol 14:141–147
Schoenberg MP, Gonzalgo ML (2006) Management of invasive and metastatic bladder cancer. In: Wein AJ, Kavoussi LR, Novick AC, Partin AW, Peters CA (eds) Campbell-Walsh urology, 9th edn. Saunders, Philadelphia, PA, pp 2468–2478
Menon M, Hemal AK, Tewari A, Shrivastava A, Shoma AM, El-Tabey NA, Shaaban A, Abol-Enein H, Ghoneim MA (2003) Nerve-sparing robot-assisted radical cystoprostatectomy and urinary diversion. BJU Int 92:232–236
Guru KA, Kim HL, Piacente PM, Mohler JL (2007) Robot-assisted radical cystectomy and pelvic lymph node dissection: initial experience at Roswell Park Cancer Institute. Urology 69:469–474
Pruthi RS, Wallen EM (2008) Is robotic radical cystectomy an appropriate treatment for bladder cancer: short-term oncoloic and clnical follow-up in 50 consecutive patients. Urology 72:617–620
Khan MS, Shah SS, Hemel A, Rimington P, Dasgupta P (2008) Robotic-assisted radical cystectomy. Int J Med Robot 4:197–201
Chamie KC, Hu B, deVere White RW, Ellison LM (2008) Cystectomy in the elderly: does the survival benefit in younger patients translate to the octogenarians? BJU Int 102:284–290
Cooke PW, Dunn JA, Latief T, Bathers S, James ND, Wallace DM (2000) Long-term risk of salvage cystectomy after radiotherapy for muscle-invasive bladder cancer. Eur Urol 38:279–286
Nieuwenhuijzen JA, Horenblas S, Meinhardt W, van Tinteren H, Moonen LM (2004) Salvage cystectomy after failure of interstitial radiotherapy and external beam radiotherapy for bladder cancer. BJU Int 94:793–797
Menon M, Hemal AK, Tewari A, Shrivastava A, Shoma AM, Abol-Ein H, Ghoneim MA (2004) Robot-assisted radical cystectomy and urinary diversion in female patients: technique with preservation of the uterus and vagina. J Am Coll Surg 198:386–393
Hemal AK (2009) Robotic and laparoscopic radical cystectomy in the management of bladder cancer. Curr Urol Rep 10:45–54
Conflict of interest statement
Dr. Eandi and Dr. Chan have no competing financial interests. Dr. Wilson, Dr. Josephson and Dr. Lau are speakers and consultants for Intuitive Surgical, Inc.
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Eandi, J.A., Chan, K.G., Wilson, T.G. et al. Robotic salvage cystectomy in the nonagenarian. J Robotic Surg 3, 191–194 (2009). https://doi.org/10.1007/s11701-009-0155-5
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DOI: https://doi.org/10.1007/s11701-009-0155-5