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Port-site metastases following robotic radical cystectomy: A systematic review and management options

Khetrapal, P; Shen, TW; Lamb, B; Nathan, S; Briggs, T; Shankar, A; Ramachandran, N; ... Kelly, JD; + view all (2016) Port-site metastases following robotic radical cystectomy: A systematic review and management options. Clinical Genitourinary Cancer , 15 (4) pp. 440-444. 10.1016/j.clgc.2016.06.012. Green open access

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Abstract

BACKGROUND: Port-site metastases (PSM) are a rare occurrence in robotic surgery. For robot assisted radical cystectomy (RARC), isolated cases have been reported but management has not been described previously. We present a case of PSM that occurred after RARC and perform the results of our systematic review of previously reported port site metastases, and describe treatment options. METHODS: We describe a case of a PSM in a 55-year old gentleman who underwent intracorporeal RARC. We performed a systematic review of MEDLINE and EMBASE databases for previously reported PSMs, detailing the stage and grade of the primary tumour, time to presentation of PSM, treatment offered and outcomes for the identified cases. RESULTS: We identified four cases of PSMs following RARC in the literature, and included our case for analysis. All five cases had muscle invasive bladder cancer at time of cystectomy (>T2) and three of them had local lymph node positive disease. Our aggressive treatment of chemotherapy, wide surgical excision of PSM and radiotherapy has provided the patient a two-year disease-free status. CONCLUSION: PSMs are a rare event in RARC, with only four other cases described in the literature. Outcomes have are not well reported for all of these cases, and we propose that a multi-modality treatment consisting of salvage chemotherapy, surgery and radiotherapy should be considered, but concessions have to be made taking patient factors into account.

Type: Article
Title: Port-site metastases following robotic radical cystectomy: A systematic review and management options
Open access status: An open access version is available from UCL Discovery
DOI: 10.1016/j.clgc.2016.06.012
Publisher version: http://dx.doi.org/10.1016/j.clgc.2016.06.012
Language: English
Additional information: Copyright © 2016 Elsevier Inc. All rights reserved. This manuscript version is made available under the CC-BY-NC-ND 4.0 license (http://creativecommons.org/licenses/by-nc-nd/4.0/). The published version of record is available at http://dx.doi.org/10.1016/j.clgc.2016.06.012
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Surgery and Interventional Sci
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Surgery and Interventional Sci > Department of Targeted Intervention
URI: https://discovery.ucl.ac.uk/id/eprint/1503500
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