nach oben

Erschienen in:

01.02.2009 | Review

Oncological risk of laparoscopic surgery in urothelial carcinomas

verfasst von: Morgan Rouprêt, Gordon Smyth, Jacques Irani, Laurent Guy, Jean-Louis Davin, Fabien Saint, Christian Pfister, Hervé Wallerand, François Rozet

Erschienen in: World Journal of Urology | Ausgabe 1/2009

Einloggen, um Zugang zu erhalten

Abstract

Objective

To assess the oncological safety of laparoscopic procedures for the management of urothelial carcinomas of the urinary tract.

Methods

Data on laparoscopic management of urothelial carcinomas in the literature were analysed using MEDLINE and by matching the following keywords: urological malignancies, upper tract tumours, bladder carcinomas, laparoscopic approach, recurrence, follow-up and metastasis site.

Results

Minimally invasive techniques are being used increasingly in the management of these tumours and successfully achieving the benefits of lower blood loss and more rapid patient recovery. To date, no evidence level 1 information is available and published series of these technically challenging cases are small and follow-up limited. Short to medium term follow-up appears encouraging in terms of recurrence and survival rates, but long-term data are immature compared to the established open techniques these procedures seek to duplicate. Specific concerns in terms of the oncologic safety of laparoscopy, especially with regard to the pneumoperitoneum, tumour manipulation and specimen extraction are addressed. Port-site metastases and tumour seeding are rare events and appear to be mainly related to the grade and stage of the tumour. Specific precautions are required to minimise these risks.

Conclusion

Oncological results of the laparoscopic approach are difficult to compare with those of open surgery. However, recent series have not reported unusual tumour dissemination or a higher rate of recurrence with this approach. Laparoscopic techniques are not yet standard of care in invasive urothelial carcinomas. Long-term assessment is ongoing and awaited.

Chopin DK, Gattegno B (2002) Superficial bladder tumors. Eur Urol 42:533–541. doi:10.1016/S0302-2838(02)00466-9 PubMedCrossRef

Kirkali Z, Chan T, Manoharan M, Algaba F, Busch C, Cheng L et al (2005) Bladder cancer: epidemiology, staging and grading, and diagnosis. Urology 66:4–34. doi:10.1016/j.urology.2005.07.062 PubMedCrossRef

Hall MC, Womack S, Sagalowsky AI, Carmody T, Erickstad MD, Roehrborn CG (1998) Prognostic factors, recurrence, and survival in transitional cell carcinoma of the upper urinary tract: a 30-year experience in 252 patients. Urology 52:594–601. doi:10.1016/S0090-4295(98)00295-7 PubMedCrossRef

Tawfiek ER, Bagley DH (1997) Upper-tract transitional cell carcinoma. Urology 50:321–329. doi:10.1016/S0090-4295(97)00230-6 PubMedCrossRef

Olgac S, Mazumdar M, Dalbagni G, Reuter VE (2004) Urothelial carcinoma of the renal pelvis: a clinicopathologic study of 130 cases. Am J Surg Pathol 28:1545–1552. doi:10.1097/00000478-200412000-00001 PubMedCrossRef

van der Poel HG, Antonini N, van Tinteren H, Horenblas S (2005) Upper urinary tract cancer: location is correlated with prognosis. Eur Urol 48:438–444PubMed

Rassweiler J, Tsivian A, Kumar AV, Lymberakis C, Schulze M, Seeman O et al (2003) Oncological safety of laparoscopic surgery for urological malignancy: experience with more than 1,000 operations. J Urol 169:2072–2075. doi:10.1097/01.ju.0000067469.01244.5c PubMedCrossRef

Touijer K, Guillonneau B (2006) Laparoscopic radical prostatectomy: a critical analysis of surgical quality. Eur Urol 49:625–632. doi:10.1016/j.eururo.2006.01.018 PubMedCrossRef

Cicco A, Salomon L, Hoznek H, Alame W, Saint F, Bralet MP et al (2000) Carcinological risks and retroperitoneal laparoscopy. Eur Urol 38:606–612. doi:10.1159/000020339 PubMedCrossRef

10.

El-Tabey NA, Shoma AM (2005) Port site metastases after robot-assisted laparoscopic radical cystectomy. Urology 66:1110PubMed

11.

Highshaw RA, Vakar-Lopez F, Jonasch E, Yasko AW, Matin SF (2005) Port-site metastasis: the influence of biology. Eur Urol 47:357–360. doi:10.1016/j.eururo.2004.11.008 PubMedCrossRef

12.

Micali S, Celia A, Bove P, De Stefani S, Sighinolfi MC, Kavoussi LR et al (2004) Tumor seeding in urological laparoscopy: an international survey. J Urol 171:2151–2154. doi:10.1097/01.ju.0000124929.05706.6b PubMedCrossRef

13.

Ong AM, Bhayani SB, Pavlovich CP (2003) Trocar site recurrence after laparoscopic nephroureterectomy. J Urol 170:1301. doi:10.1097/01.ju.0000084660.73614.da PubMedCrossRef

14.

Paolucci V, Schaeff B, Schneider M, Gutt C (1999) Tumor seeding following laparoscopy: international survey. World J Surg 23:989–997. doi:10.1007/s002689900613 PubMedCrossRef

15.

Mondet F, Boyer C, Esterni JP (2004) Early metastatic dissemination after nephro-ureterectomy for upper urinary tract tumour: a possible role of laparoscopy? Prog Urol 14:1203–1205PubMed

16.

Naderi N, Nieuwenhuijzen JA, Bex A, Kooistra A, Horenblas S (2004) Port site metastasis after laparoscopic nephro-ureterectomy for transitional cell carcinoma. Eur Urol 46:440–441. doi:10.1016/j.eururo.2003.12.018 PubMedCrossRef

17.

Cathelineau X, Arroyo C, Rozet F, Barret E, Vallancien G (2005) Laparoscopic assisted radical cystectomy: the montsouris experience after 84 cases. Eur Urol 47:780–784. doi:10.1016/j.eururo.2005.04.001 PubMedCrossRef

18.

Haber GP, Gill IS (2007) Laparoscopic radical cystectomy for cancer: oncological outcomes at up to 5 years. BJU Int 100:137–142. doi:10.1111/j.1464-410X.2007.06865.x PubMedCrossRef

19.

Rassweiler JJ, Schulze M, Marrero R, Frede T, Palou Redorta J, Bassi P (2004) Laparoscopic nephroureterectomy for upper urinary tract transitional cell carcinoma: is it better than open surgery? Eur Urol 46:690–697. doi:10.1016/j.eururo.2004.08.006 PubMedCrossRef

20.

Roupret M, Hupertan V, Sanderson KM, Harmon JD, Cathelineau X, Barret E et al (2007) Oncologic control after open or laparoscopic nephroureterectomy for upper urinary tract transitional cell carcinoma: a single center experience. Urology 69:656–661. doi:10.1016/j.urology.2007.01.007 PubMedCrossRef

21.

Stein JP, Lieskovsky G, Cote R, Groshen S, Feng AC, Boyd S et al (2001) Radical cystectomy in the treatment of invasive bladder cancer: long-term results in 1,054 patients. J Clin Oncol 19:666–675PubMed

22.

Tsujihata M, Nonomura N, Tsujimura A, Yoshimura K, Miyagawa Y, Okuyama A (2006) Laparoscopic nephroureterectomy for upper tract transitional cell carcinoma: comparison of laparoscopic and open surgery. Eur Urol 49:332–336. doi:10.1016/j.eururo.2005.11.013 PubMedCrossRef

23.

Clayman RV, Kavoussi LR, Figenshau RS, Chandhoke PS, Albala DM (1991) Laparoscopic nephroureterectomy: initial clinical case report. J Laparoendosc Surg 1:343–349PubMed

24.

Bariol SV, Stewart GD, McNeill SA, Tolley DA (2004) Oncological control following laparoscopic nephroureterectomy: 7-year outcome. J Urol 172:1805–1808. doi:10.1097/01.ju.0000140995.44338.58 PubMedCrossRef

25.

Muntener M, Nielsen ME, Romero FR, Schaeffer EM, Allaf ME, Brito FA et al (2007) Long-term oncologic outcome after laparoscopic radical nephroureterectomy for upper tract transitional cell carcinoma. Eur Urol 51:1639–1644. doi:10.1016/j.eururo.2007.01.038 PubMedCrossRef

26.

Argyropoulos AN, Tolley DA (2007) Upper urinary tract transitional cell carcinoma: current treatment overview of minimally invasive approaches. BJU Int 99:982–987. doi:10.1111/j.1464-410X.2007.06870.x PubMedCrossRef

27.

Chung SD, Chueh SC, Lai MK, Huang CY, Pu YS, Yu HJ et al (2007) Long-term outcome of hand-assisted laparoscopic radical nephroureterectomy for upper-tract urothelial carcinoma: comparison with open surgery. J Endourol 21:595–599. doi:10.1089/end.2006.9948 PubMedCrossRef

28.

Kawauchi A, Fujito A, Ukimura O, Yoneda K, Mizutani Y, Miki T (2003) Hand assisted retroperitoneoscopic nephroureterectomy: comparison with the open procedure. J Urol 169:890–894. doi:10.1097/01.ju.0000046453.38141.dd PubMedCrossRef

29.

Chueh SC, Tsai ID, Lai MK (2004) Solitary port-site metastasis after laparoscopic bilateral nephroureterctomy for transitional cell carcinoma in a renal transplant recipient. Transpl Proc 36:2697–2698. doi:10.1016/j.transproceed.2004.09.074 CrossRef

30.

Klingler HC, Lodde M, Pycha A, Remzi M, Janetschek G, Marberger M (2003) Modified laparoscopic nephroureterectomy for treatment of upper urinary tract transitional cell cancer is not associated with an increased risk of tumour recurrence. Eur Urol 44:442–447. doi:10.1016/S0302-2838(03)00314-2 PubMedCrossRef

31.

Jarrett TW, Chan DY, Cadeddu JA, Kavoussi LR (2001) Laparoscopic nephroureterectomy for the treatment of transitional cell carcinoma of the upper urinary tract. Urology 57:448–453. doi:10.1016/S0090-4295(00)01043-8 PubMedCrossRef

32.

Tanaka K, Hara I, Takenaka A, Kawabata G, Fujisawa M (2008) Incidence of local and port site recurrence of urologic cancer after laparoscopic surgery. Urology 71:728–734. doi:10.1016/j.urology.2007.10.054 PubMedCrossRef

33.

Hattori R, Yoshino Y, Gotoh M, Katoh M, Kamihira O, Ono Y (2006) Laparoscopic nephroureterectomy for transitional cell carcinoma of renal pelvis and ureter: Nagoya experience. Urology 67:701–705. doi:10.1016/j.urology.2005.10.022 PubMedCrossRef

34.

Salomon L, Hoznek A, Cicco A, Gasman D, Chopin DK, Abbou CC (1999) Retroperitoneoscopic nephroureterectomy for renal pelvic tumors with a single iliac incision. J Urol 161:541–544. doi:10.1016/S0022-5347(01)61945-1 PubMedCrossRef

35.

Hsueh TY, Huang YH, Chiu AW, Huan SK, Lee YH (2007) Survival analysis in patients with upper urinary tract transitional cell carcinoma: a comparison between open and hand-assisted laparoscopic nephroureterectomy. BJU Int 99:632–636. doi:10.1111/j.1464-410X.2006.06665.x PubMedCrossRef

36.

Oosterlinck W, Solsona E, van der Meijden AP, Sylvester R, Bohle A, Rintala E et al (2004) EAU guidelines on diagnosis and treatment of upper urinary tract transitional cell carcinoma. Eur Urol 46:147–154. doi:10.1016/j.eururo.2004.04.011 PubMedCrossRef

37.

Pohar KS, Sheinfeld J (2001) When is partial ureterectomy acceptable for transitional-cell carcinoma of the ureter? J Endourol 15:405–409. doi:10.1089/089277901300189439 PubMedCrossRef

38.

Roupret M, Harmon JD, Sanderson KM, Barret E, Cathelineau X, Vallancien G et al (2007) Laparoscopic distal ureterectomy and anastomosis for management of low-risk upper urinary tract transitional cell carcinoma: preliminary results. BJU Int 99:623–627. doi:10.1111/j.1464-410X.2006.06688.x PubMedCrossRef

39.

Chandhoke PS, Clayman RV, Kerbl K, Figenshau RS, McDougall EM, Kavoussi LR et al (1993) Laparoscopic ureterectomy: initial clinical experience. J Urol 149:992–997PubMed

40.

Gerber E, Dinlenc CZ, Wagner JR (2003) Laparoscopic distal ureterectomy for low grade transitional cell carcinoma. J Urol 169:2295. doi:10.1097/01.ju.0000060883.54360.cd PubMedCrossRef

41.

Simforoosh N, Mosapour E, Maghsudi R (2005) Laparoscopic ureteral resection and anastomosis for management of low-grade transitional-cell carcinoma. J Endourol 19:287–289. doi:10.1089/end.2005.19.287 PubMedCrossRef

42.

Scolieri MJ, Paik ML, Brown SL, Resnick MI (2000) Limitations of computed tomography in the preoperative staging of upper tract urothelial carcinoma. Urology 56:930–934. doi:10.1016/S0090-4295(00)00800-1 PubMedCrossRef

43.

Elliott DS, Segura JW, Lightner D, Patterson DE, Blute ML (2001) Is nephroureterectomy necessary in all cases of upper tract transitional cell carcinoma? Long-term results of conservative endourologic management of upper tract transitional cell carcinoma in individuals with a normal contralateral kidney. Urology 58:174–178. doi:10.1016/S0090-4295(01)01109-8 PubMedCrossRef

44.

Roupret M, Hupertan V, Traxer O, Loison G, Chartier-Kastler E, Conort P et al (2006) Comparison of open nephroureterectomy and ureteroscopic and percutaneous management of upper urinary tract transitional cell carcinoma. Urology 67:1181–1187. doi:10.1016/j.urology.2005.12.034 PubMedCrossRef

45.

Oosterlinck W, Lobel B, Jakse G, Malmstrom PU, Stockle M, Sternberg C (2002) Guidelines on bladder cancer. Eur Urol 41:105–112. doi:10.1016/S0302-2838(01)00026-4 PubMedCrossRef

46.

Sanchez de Badajoz E, Gallego Perales JL, Reche Rosado A, Gutierrez de la Cruz JM, Jimenez Garrido A (1995) Laparoscopic cystectomy and ileal conduit: case report. J Endourol 9:59–62PubMed

47.

Huang J, Lin T, Xu K, Huang H, Jiang C, Han J et al (2008) Laparoscopic radical cystectomy with orthotopic ileal neobladder: a report of 85 cases. J Endourol 22:939–946. doi:10.1089/end.2007.0298 PubMedCrossRef

48.

Basillote JB, Abdelshehid C, Ahlering TE, Shanberg AM (2004) Laparoscopic assisted radical cystectomy with ileal neobladder: a comparison with the open approach. J Urol 172:489–493. doi:10.1097/01.ju.0000129662.83162.2e PubMedCrossRef

49.

DeGer S, Peters R, Roigas J, Wille AH, Tuerk IA, Loening SA (2004) Laparoscopic radical cystectomy with continent urinary diversion (rectosigmoid pouch) performed completely intracorporeally: an intermediate functional and oncologic analysis. Urology 64:935–939. doi:10.1016/j.urology.2004.07.004 PubMedCrossRef

50.

Hemal AK, Kolla SB, Wadhwa P, Dogra PN, Gupta NP (2008) Laparoscopic radical cystectomy and extracorporeal urinary diversion: a single center experience of 48 cases with three years of follow-up. Urology 71:41–46. doi:10.1016/j.urology.2007.08.056 PubMedCrossRef

51.

Vaessen C, Mouzin M, Malavaud B, Game X, Berrogain N, Rischmann P (2004) Laparoscopic cystoprostatectomy, initial experience: 13 patients. Prog Urol 14:590–593PubMed

52.

Menon M, Hemal AK, Tewari A, Shrivastava A, Shoma AM, El-Tabey NA et al (2003) Nerve-sparing robot-assisted radical cystoprostatectomy and urinary diversion. BJU Int 92:232–236. doi:10.1046/j.1464-410X.2003.04329.x PubMedCrossRef

53.

Pruthi RS, Wallen EM (2007) Robotic assisted laparoscopic radical cystoprostatectomy: operative and pathological outcomes. J Urol 178:814–818. doi:10.1016/j.juro.2007.05.040 PubMedCrossRef

54.

Wang GJ, Barocas DA, Raman JD, Scherr DS (2008) Robotic vs open radical cystectomy: prospective comparison of perioperative outcomes and pathological measures of early oncological efficacy. BJU Int 101:89–93PubMed

55.

Haber GP, Campbell SC, Colombo JR Jr, Fergany AF, Aron M, Kaouk J et al (2007) Perioperative outcomes with laparoscopic radical cystectomy: “pure laparoscopic” and “open-assisted laparoscopic” approaches. Urology 70:910–915. doi:10.1016/j.urology.2007.07.012 PubMedCrossRef

56.

Porpiglia F, Renard J, Billia M, Scoffone C, Cracco C, Terrone C et al (2007) Open versus laparoscopy-assisted radical cystectomy: results of a prospective study. J Endourol 21:325–329. doi:10.1089/end.2006.0224 PubMedCrossRef

57.

Hemal AK, Kolla SB (2007) Comparison of laparoscopic and open radical cystoprostatectomy for localized bladder cancer with 3-year oncological followup: a single surgeon experience. J Urol 178:2340–2343. doi:10.1016/j.juro.2007.08.020 PubMedCrossRef

58.

Guru KA, Pruthi RS, Wallen EM, Muhltaler F, Mohler JL, Kim HL et al (2008) International robot-assisted cystectomy consortium (IRCC): immediate oncologic results after one hundred and sixty-two cases. J Urol 179 (Abstract 850)

59.

Elbahnasy AM, Hoenig DM, Shalhav A, McDougall EM, Clayman RV (1998) Laparoscopic staging of bladder tumor: concerns about port site metastases. J Endourol 12:55–59PubMedCrossRef

60.

Simonato A, Gregori A, Lissiani A, Bozzola A, Galli S, Gaboardi F (2003) Laparoscopic radical cystoprostatectomy: a technique illustrated step by step. Eur Urol 44:132–138. doi:10.1016/S0302-2838(03)00214-8 PubMedCrossRef

61.

Stolla V, Rossi D, Bladdou F, Rattier C, Ayuso D, Serment G (1994) Subcutaneous metastases after coelioscopic lymphadenectomy for vesical urothelial carcinoma. Eur Urol 26:342–343PubMed

62.

Castillo OA, Vitagliano G (2008) Port site metastasis and tumor seeding in oncologic laparoscopic urology. Urology 71:372–378. doi:10.1016/j.urology.2007.10.064 PubMedCrossRef

63.

Castillo OA, Abreu SC, Mariano MB, Tefilli MV, Hoyos J, Pinto I et al (2006) Complications in laparoscopic radical cystectomy. The South American experience with 59 cases. Int Braz J Urol 32:300–305PubMed

64.

Simonato A, Gregori A, Lissiani A, Bozzola A, Galli S, Gaboardi F (2005) Laparoscopic radical cystoprostatectomy: our experience in a consecutive series of 10 patients with a 3 years follow-up. Eur Urol 47:785–792. doi:10.1016/j.eururo.2005.02.011 PubMedCrossRef

65.

Fergany AF, Gill IS (2008) Laparoscopic radical cystectomy. Urol Clin N Am 35:455–466, viii–ix. doi:10.1016/j.ucl.2008.05.002

Titel: Oncological risk of laparoscopic surgery in urothelial carcinomas
verfasst von: Morgan Rouprêt
Gordon Smyth
Jacques Irani
Laurent Guy
Jean-Louis Davin
Fabien Saint
Christian Pfister
Hervé Wallerand
François Rozet
Publikationsdatum: 01.02.2009
Verlag: Springer-Verlag
Erschienen in: World Journal of Urology / Ausgabe 1/2009
Print ISSN: 0724-4983
Elektronische ISSN: 1433-8726
DOI: https://doi.org/10.1007/s00345-008-0349-x

Neu im Fachgebiet Urologie

Adjuvante Immuntherapie verlängert Leben bei RCC

25.04.2024 Nierenkarzinom Nachrichten

Nun gibt es auch Resultate zum Gesamtüberleben: Eine adjuvante Pembrolizumab-Therapie konnte in einer Phase-3-Studie das Leben von Menschen mit Nierenzellkarzinom deutlich verlängern. Die Sterberate war im Vergleich zu Placebo um 38% geringer.

Bei Senioren mit Prostatakarzinom auf Anämie achten!

24.04.2024 DGIM 2024 Nachrichten

Patienten, die zur Behandlung ihres Prostatakarzinoms eine Androgendeprivationstherapie erhalten, entwickeln nicht selten eine Anämie. Wer ältere Patienten internistisch mitbetreut, sollte auf diese Nebenwirkung achten.

Stufenschema weist Prostatakarzinom zuverlässig nach

22.04.2024 Prostatakarzinom Nachrichten

Erst PSA-Test, dann Kallikrein-Score, schließlich MRT und Biopsie – ein vierstufiges Screening-Schema kann die Zahl der unnötigen Prostatabiopsien erheblich reduzieren: Die Hälfte der Männer, die in einer finnischen Studie eine Biopsie benötigten, hatte einen hochgradigen Tumor.

Harnwegsinfektprophylaxe: Es geht auch ohne Antibiotika

20.04.2024 EAU 2024 Kongressbericht

Beim chronischen Harnwegsinfekt bei Frauen wird bisher meist eine Antibiotikaprophylaxe eingesetzt. Angesichts der zunehmenden Antibiotikaresistenz erweist sich das Antiseptikum Methenamin-Hippurat als vielversprechende Alternative, so die Auswertung einer randomisierten kontrollierten Studie.

Update Urologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Springer Medizin

Abstract

Objective

Methods

Results

Conclusion

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 1/2009

Prognostic factors in T3b renal cell carcinoma

Pediatric enterocystoplasty: long-term complications and controversies

Immunoscreening of urinary bladder cancer cDNA library and identification of potential tumor antigen

Long-term survival after sequential chemoradiation for limited disease small cell carcinoma of the bladder