Mid-term oncological control after laparoscopic radical cystectomy in men: a single-centre experience

Study Type – Therapy (case series) Level of Evidence 4

OBJECTIVE

? 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.

PATIENTS AND METHODS

? 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).

RESULTS

? 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%).

CONCLUSION

? 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.