1405 LYMPH NODE YIELD AND PREDICTORS OF EXTENDED LYMPHADENECTOMY AT THE TIME OF ROBOT-ASSISTED RADICAL CYSTECTOMY: RESULTS FROM THE INTERNATIONAL ROBOTIC CYSTECTOMY CONSORTIUM (2011)

You have accessJournal of UrologyBladder Cancer: Invasive1 Apr 20111405 LYMPH NODE YIELD AND PREDICTORS OF EXTENDED LYMPHADENECTOMY AT THE TIME OF ROBOT-ASSISTED RADICAL CYSTECTOMY: RESULTS FROM THE INTERNATIONAL ROBOTIC CYSTECTOMY CONSORTIUM Susan J. Marshall, Matthew H. Hayn, Andrew P. Stegemann, Piyush K. Agarwal, Ketan K. Badani, M. Derya Balbay, Erik P. Castle, Prokar Dasgupta, Ashok K. Hemal, David Josephson, A. Karim Kader, Adam S. Kibel, Alex Mottrie, Kenneth Nepple, John G. Pattaras, James O. Peabody, Vassilis Poulakis, Raj S. Pruthi, Joan Palou Redorta, Koon-Ho Rha, Lee Richstone, Matthias Saar, Douglas S. Scherr, Stefan Siemer, Michael Stoeckle, Eric M. Wallen, Peter Wiklund, Timothy Wilson, Michael Woods, Bertram Yuh, and Khurshid A. Guru Susan J. MarshallSusan J. Marshall Buffalo, NY More articles by this author , Matthew H. HaynMatthew H. Hayn Buffalo, NY More articles by this author , Andrew P. StegemannAndrew P. Stegemann Buffalo, NY More articles by this author , Piyush K. AgarwalPiyush K. Agarwal Detroit, MI More articles by this author , Ketan K. BadaniKetan K. Badani New York, NY More articles by this author , M. Derya BalbayM. Derya Balbay Ankara, Turkey More articles by this author , Erik P. CastleErik P. Castle Scottsdale, AZ More articles by this author , Prokar DasguptaProkar Dasgupta London, United Kingdom More articles by this author , Ashok K. HemalAshok K. Hemal Winston-Salem, NC More articles by this author , David JosephsonDavid Josephson Duarte, CA More articles by this author , A. Karim KaderA. Karim Kader Winston-Salem, NC More articles by this author , Adam S. KibelAdam S. Kibel St. Louis, MO More articles by this author , Alex MottrieAlex Mottrie Aalst, Belgium More articles by this author , Kenneth NeppleKenneth Nepple St. Louis, MO More articles by this author , John G. PattarasJohn G. Pattaras Atlanta, GA More articles by this author , James O. PeabodyJames O. Peabody Detroit, MI More articles by this author , Vassilis PoulakisVassilis Poulakis Athens, Greece More articles by this author , Raj S. PruthiRaj S. Pruthi Chapel Hill, NC More articles by this author , Joan Palou RedortaJoan Palou Redorta Barcelona, Spain More articles by this author , Koon-Ho RhaKoon-Ho Rha Seoul, Korea, Republic of More articles by this author , Lee RichstoneLee Richstone New Hyde Park, NY More articles by this author , Matthias SaarMatthias Saar Homburg, Germany More articles by this author , Douglas S. ScherrDouglas S. Scherr New York, NY More articles by this author , Stefan SiemerStefan Siemer Homburg, Germany More articles by this author , Michael StoeckleMichael Stoeckle Homburg, Germany More articles by this author , Eric M. WallenEric M. Wallen Chapel Hill, NC More articles by this author , Peter WiklundPeter Wiklund Stockholm, Sweden More articles by this author , Timothy WilsonTimothy Wilson Duarte, CA More articles by this author , Michael WoodsMichael Woods Maywood, IL More articles by this author , Bertram YuhBertram Yuh Duarte, CA More articles by this author , and Khurshid A. GuruKhurshid A. Guru Buffalo, NY More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2011.02.1296AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES To evaluate the lymph node yield (LNY), incidence of, and predictors for, extended lymphadenectomy in patients undergoing robot-assisted radical cystectomy (RARC) for bladder cancer. METHODS Utilizing the International Robotic Cystectomy Consortium (IRCC) database, 1078 patients who underwent RARC at 18 institutions from 2003–2010 were evaluated for their lymph node yield. Average LNY was determined after stratification by age, sex, clinical stage, institutional volume, sequential case number, and surgeon volume. Data on extent of lymphadenectomy was available for 576 patients. Logistic regression was used to correlate variables to the likelihood of undergoing extended lymphadenectomy. RESULTS Of the 1078 patients, 1038 (96%) underwent lymphadenectomy. A mean of 19 (range 1–74) lymph nodes were examined. High volume institutions (>100 cases) had a higher mean LNY (21 vs 15, p<0.001). Sixty-seven percent of patients (390/576) underwent extended lymphadenectomy. There was no difference in LNY by age group (p=0.383), pathologic stage (p=0.407), and gender (p=0.784). Patients with prior abdominal surgery had a lower mean LNY (18 vs 21, p=0.004), while obese patients had a higher mean LNY (21 vs 19, p=0.014). Twenty-two percent (n=206) of patients had positive lymph nodes. On univariable analysis, surgeon volume, increasing age, institutional volume, and sequential case number were associated with likelihood of undergoing extended lymphadenectomy. On multivariable analysis, surgeon volume ≥51 cases (OR 6.52, 95% CI 1.34–31.7, p=0.020) and advanced clinical stage (OR 1.87, 95% CI 1.13–3.10, p=0.015) were independently associated with undergoing extended lymphadenectomy. CONCLUSIONS Robot-assisted lymphadenectomy can achieve similar lymph node yields to those of open lymphadenectomy after radical cystectomy. High volume surgeons are more likely to perform an extended lymphadenectomy, reflecting a correlation between increasing surgeon comfort with advanced vascular dissection and their growing experience. © 2011 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 185Issue 4SApril 2011Page: e562-e563 Advertisement Copyright & Permissions© 2011 by American Urological Association Education and Research, Inc.Metrics Author Information Susan J. Marshall Buffalo, NY More articles by this author Matthew H. Hayn Buffalo, NY More articles by this author Andrew P. Stegemann Buffalo, NY More articles by this author Piyush K. Agarwal Detroit, MI More articles by this author Ketan K. Badani New York, NY More articles by this author M. Derya Balbay Ankara, Turkey More articles by this author Erik P. Castle Scottsdale, AZ More articles by this author Prokar Dasgupta London, United Kingdom More articles by this author Ashok K. Hemal Winston-Salem, NC More articles by this author David Josephson Duarte, CA More articles by this author A. Karim Kader Winston-Salem, NC More articles by this author Adam S. Kibel St. Louis, MO More articles by this author Alex Mottrie Aalst, Belgium More articles by this author Kenneth Nepple St. Louis, MO More articles by this author John G. Pattaras Atlanta, GA More articles by this author James O. Peabody Detroit, MI More articles by this author Vassilis Poulakis Athens, Greece More articles by this author Raj S. Pruthi Chapel Hill, NC More articles by this author Joan Palou Redorta Barcelona, Spain More articles by this author Koon-Ho Rha Seoul, Korea, Republic of More articles by this author Lee Richstone New Hyde Park, NY More articles by this author Matthias Saar Homburg, Germany More articles by this author Douglas S. Scherr New York, NY More articles by this author Stefan Siemer Homburg, Germany More articles by this author Michael Stoeckle Homburg, Germany More articles by this author Eric M. Wallen Chapel Hill, NC More articles by this author Peter Wiklund Stockholm, Sweden More articles by this author Timothy Wilson Duarte, CA More articles by this author Michael Woods Maywood, IL More articles by this author Bertram Yuh Duarte, CA More articles by this author Khurshid A. Guru Buffalo, NY More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...