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

89 Citations (Scopus)

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
Pages (from-to)87-91
Number of pages5
JournalJournal of Urology
Volume184
Issue number1
DOIs
StatePublished - Jul 1 2010

Fingerprint

Cystectomy
Robotics
Urinary Bladder Neoplasms
Age Groups
Learning Curve
Margins of Excision
Logistic Models
Lymph Nodes
Databases
Incidence

Keywords

  • carcinoma
  • cystectomy
  • robotics
  • urinary bladder
  • urothelium

ASJC Scopus subject areas

  • Urology

Cite this

Hellenthal, N. J., Hussain, A., Andrews, P. E., Carpentier, P., Castle, E., Dasgupta, P., ... 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

Surgical Margin Status After Robot Assisted Radical Cystectomy : Results From the International Robotic Cystectomy Consortium. / Hellenthal, Nicholas J.; Hussain, Abid; Andrews, Paul E.; Carpentier, Paul; Castle, Erik; Dasgupta, Prokar; Kaouk, Jihad; Khan, Shamim; Kibel, Adam; Kim, Hyung; Manoharan, Murugesan; Menon, Mani; Mottrie, Alex; Ornstein, David; Palou, Joan; Peabody, James; Pruthi, Raj; Richstone, Lee; Schanne, Francis; Stricker, Hans; Thomas, Raju; Wiklund, Peter; Wilding, Greg; Guru, Khurshid A.

In: Journal of Urology, Vol. 184, No. 1, 01.07.2010, p. 87-91.

Research output: Contribution to journalArticle

Hellenthal, NJ, Hussain, A, Andrews, PE, 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, Stricker, H, Thomas, R, Wiklund, P, Wilding, G & Guru, KA 2010, 'Surgical Margin Status After Robot Assisted Radical Cystectomy: Results From the International Robotic Cystectomy Consortium', Journal of Urology, vol. 184, no. 1, pp. 87-91. https://doi.org/10.1016/j.juro.2010.03.037
Hellenthal, Nicholas J. ; Hussain, Abid ; Andrews, Paul E. ; Carpentier, Paul ; Castle, Erik ; Dasgupta, Prokar ; Kaouk, Jihad ; Khan, Shamim ; Kibel, Adam ; Kim, Hyung ; Manoharan, Murugesan ; Menon, Mani ; Mottrie, Alex ; Ornstein, David ; Palou, Joan ; Peabody, James ; Pruthi, Raj ; Richstone, Lee ; Schanne, Francis ; Stricker, Hans ; Thomas, Raju ; Wiklund, Peter ; Wilding, Greg ; Guru, Khurshid A. / Surgical Margin Status After Robot Assisted Radical Cystectomy : Results From the International Robotic Cystectomy Consortium. In: Journal of Urology. 2010 ; Vol. 184, No. 1. pp. 87-91.
@article{8583872700654781adfa2364cfa07fae,
title = "Surgical Margin Status After Robot Assisted Radical Cystectomy: Results From the International Robotic Cystectomy Consortium",
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.",
keywords = "carcinoma, cystectomy, robotics, urinary bladder, urothelium",
author = "Hellenthal, {Nicholas J.} and Abid Hussain and Andrews, {Paul E.} and Paul Carpentier and Erik Castle and Prokar Dasgupta and Jihad Kaouk and Shamim Khan and Adam Kibel and Hyung Kim and Murugesan Manoharan and Mani Menon and Alex Mottrie and David Ornstein and Joan Palou and James Peabody and Raj Pruthi and Lee Richstone and Francis Schanne and Hans Stricker and Raju Thomas and Peter Wiklund and Greg Wilding and Guru, {Khurshid A.}",
year = "2010",
month = "7",
day = "1",
doi = "10.1016/j.juro.2010.03.037",
language = "English",
volume = "184",
pages = "87--91",
journal = "Journal of Urology",
issn = "0022-5347",
publisher = "Elsevier Inc.",
number = "1",

}

TY - JOUR

T1 - Surgical Margin Status After Robot Assisted Radical Cystectomy

T2 - Results From the International Robotic Cystectomy Consortium

AU - Hellenthal, Nicholas J.

AU - Hussain, Abid

AU - Andrews, Paul E.

AU - Carpentier, Paul

AU - Castle, Erik

AU - Dasgupta, Prokar

AU - Kaouk, Jihad

AU - Khan, Shamim

AU - Kibel, Adam

AU - Kim, Hyung

AU - Manoharan, Murugesan

AU - Menon, Mani

AU - Mottrie, Alex

AU - Ornstein, David

AU - Palou, Joan

AU - Peabody, James

AU - Pruthi, Raj

AU - Richstone, Lee

AU - Schanne, Francis

AU - Stricker, Hans

AU - Thomas, Raju

AU - Wiklund, Peter

AU - Wilding, Greg

AU - Guru, Khurshid A.

PY - 2010/7/1

Y1 - 2010/7/1

N2 - 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.

AB - 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.

KW - carcinoma

KW - cystectomy

KW - robotics

KW - urinary bladder

KW - urothelium

UR - http://www.scopus.com/inward/record.url?scp=77953119958&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=77953119958&partnerID=8YFLogxK

U2 - 10.1016/j.juro.2010.03.037

DO - 10.1016/j.juro.2010.03.037

M3 - Article

C2 - 20478596

AN - SCOPUS:77953119958

VL - 184

SP - 87

EP - 91

JO - Journal of Urology

JF - Journal of Urology

SN - 0022-5347

IS - 1

ER -