(HealthDay News) — Early unexpected recurrences after laparoscopic radical cystectomy occur in 8.7% of patients with favorable pathological characteristics, according to a study published in The Journal of Urology.

In an effort to analyze patients who experienced progression despite having favorable characteristics, Simone Albisinni, MD, from the Université Libre de Bruxelles in Belgium, and colleagues used information from the European Association of Urology Section of Uro-Technology database of patients undergoing laparoscopic radical cystectomy. The authors examined risk factors for early recurrence, focusing on surgical techniques.

A total of 627 patients were followed for a median of 46 months. Of these, 311 patients had favorable pathological characteristics of pT2 N0 R0 or less. The researchers found that in the first 24 months, 8.7% of patients experienced disease progression. Only one case involved surgical negligence. The majority of those with early recurrence had progression to high tumor volume disseminated metastatic disease. Tumor stage was the only factor significantly associated with early recurrence on multivariate analysis (P=.027).

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“We report early unexpected recurrences after laparoscopic radical cystectomy in nearly 5% of our entire cohort, all in patients with favorable pathological characteristics (pT2 N0 R0 or less),” the authors write. “Specifically designed studies are necessary to investigate the possible role of pneumoperitoneum in urothelial cancer recurrence.”

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1. Albisinni S, Fossion L, Oderda M, et al. Critical Analysis of Early Recurrence after Laparoscopic Radical Cystectomy in a Large Cohort by the ESUT. J Urol 195,6;1710–1717. doi:10.1016/j.juro.2016.01.008.
2. Navai N and Dinney CPN. Oncologic Equivalence between Laparoscopic/Robotic and Open Radical Cystectomy. J Urol doi:10.1016/j.juro.2016.03.067.