Port-site metastasis and atypical recurrences after robotic-assisted radical cystectomy (RARC): an updated comprehensive and systematic review of current evidences

Guglielmo Mantica, Salvatore Smelzo, Francesca Ambrosini, Stefano Tappero, Stefano Parodi, Andrea Pacchetti, Davide De Marchi, Franco Gaboardi, Nazareno Suardi, Carlo Terrone

Research output: Contribution to journalReview article

Abstract

The objective of this systematic review is to evaluate the current evidence regarding atypical metastases in patients undergoing robotic-assisted radical cystectomy (RARC). A review of the current literature was conducted through the Medline and NCBI PubMed, Cochrane Central Register of Controlled Trials (CENTRAL) and Google Scholar databases in October 2019. From the literature search using the cited keys and after a careful evaluation of the full texts, we included 31 articles in the study. Fourteen studies (45.2%) reported at least an atypical recurrence during the follow-up period with a rate between 4 and 40% of all the recurrences. Overall, 105 (1.63%) of the 6720 patients who have been evaluated in the included studies developed an atypical recurrence. Sixty-three (60%) of these atypical metastases were peritoneal carcinomatosis, 16 (15.2%) extrapelvic lymph nodes metastases, 11 (10.5%) port-site metastases, 10 (9.5%) retroperitoneal nodal metastases, while 5 (3.8%) patients developed more than one type of atypical recurrence. In literature, there is a low but not negligible incidence of atypical recurrences after RARC. However, publication bias and retrospective design of most studies could influence the evidences. Further prospective randomized studies are needed to clarify the real risk of patients undergoing RARC to develop atypical metastases.

Original languageEnglish
JournalJournal of Robotic Surgery
DOIs
Publication statusAccepted/In press - Jan 1 2020

Keywords

  • Atypical recurrence
  • Bladder cancer
  • Cystectomy
  • Port-site metastases
  • RARC

ASJC Scopus subject areas

  • Surgery
  • Health Informatics

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