Surgical Margin Status After Robot Assisted Radical Cystectomy: Results From the International Robotic Cystectomy Consortium

Nicholas J. Hellenthal, Abid Hussain, Paul E. Andrews, Paul Carpentier, Erik Castle, Prokar Dasgupta, Jihad Kaouk, Shamim Khan, Adam Kibel, Hyung Kim, Murugesan Manoharan, Mani Menon, Alex Mottrie, David Ornstein, Joan Palou, James Peabody, Raj Pruthi, Lee Richstone, Francis Schanne, Hans StrickerRaju Thomas, Peter Wiklund, Greg Wilding, Khurshid A. Guru

Research output: Contribution to journalArticle

91 Scopus citations

Abstract

Purpose: Positive surgical margins at radical cystectomy confer a poor prognosis. We evaluated the incidence and predictors of positive surgical margins in patients who underwent robot assisted radical cystectomy for bladder cancer. Materials and Methods: Using the International Robotic Cystectomy Consortium database we identified 513 patients who underwent robot assisted radical cystectomy, as done by a total of 22 surgeons at 15 institutions from 2003 to 2009. After stratification by age group, gender, pathological T stage, nodal status, sequential case number and institutional volume logistic regression was used to correlate variables with the likelihood of a positive surgical margin. Results: Of the 513 patients 35 (6.8%) had a positive surgical margin. Increasing 10-year age group, lymph node positivity and higher pathological T stage were significantly associated with an increased likelihood of a positive margin (p = 0.010, <0.001 and p <0.001, respectively). Gender, sequential case number and institutional volume were not significantly associated with margin positivity. The rate of margin positive disease at cystectomy was 1.5% for pT2 or less, 8.8% for pT3 and 39% for pT4 disease. Conclusions: Positive surgical margin rates at robot assisted radical cystectomy for advanced bladder cancer were similar to those in open cystectomy series in a large, multi-institutional, prospective cohort. Sequential case number, a surrogate for the learning curve and institutional volume were not significantly associated with positive margins at robot assisted radical cystectomy.

Original languageEnglish (US)
Pages (from-to)87-91
Number of pages5
JournalJournal of Urology
Volume184
Issue number1
DOIs
StatePublished - Jul 2010

Keywords

  • carcinoma
  • cystectomy
  • robotics
  • urinary bladder
  • urothelium

ASJC Scopus subject areas

  • Urology

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    Hellenthal, N. J., Hussain, A., Andrews, P. E., Carpentier, P., Castle, E., Dasgupta, P., Kaouk, J., Khan, S., Kibel, A., Kim, H., Manoharan, M., Menon, M., Mottrie, A., Ornstein, D., Palou, J., Peabody, J., Pruthi, R., Richstone, L., Schanne, F., ... Guru, K. A. (2010). Surgical Margin Status After Robot Assisted Radical Cystectomy: Results From the International Robotic Cystectomy Consortium. Journal of Urology, 184(1), 87-91. https://doi.org/10.1016/j.juro.2010.03.037