Abstract: PD67-10
Sources of Funding: none

Introduction

Recently, there has been increased interest in the incidence of peritoneal carcinomatosis (PC) following radical cystectomy (RC). Particularly, pneumoperitoneum and robotic RC have been implicated as potential risk factors for peritoneal seeding. However, little has been reported on the rates of PC in open RC patients. Herein, we characterized the frequency and risk factors of PC in open RC patients in our institutional cystectomy registry.

Methods

We identified patients with urothelial carcinoma of the bladder treated for curative intent from 1980 to 2015. Patients were categorized based on recurrence pattern through our institutional cystectomy registry. We defined PC as tumor recurrence involving the omentum, small bowel and mesentery. Clinicopathologic variables were compared using 2 sample t-test and F test. Overall and cancer-specific survival was evaluated using Kaplan-Meier methodology and log rank test.

Results

Between 1980 and 2015, 3,285 patients underwent open RC. One hundred and twenty nine (3.9%) patients experienced PC, 1148 (34.9%) patients had other forms of recurrence, and 2008 (61.1%) had no recurrence. Median time to PC and other recurrence were 1.3 (IQR 1.3, 2.3) and 0.9 (IQR 0.5, 2.1) years respectively (p=0.042). Patients with PC had higher pathologic tumor and nodal stage than those with other recurrences and no recurrences (p<0.0001). Pathologic factors associated with PC include lymphovascular invasion (29.5% vs 16.7%, p=0.0002) and positive tumor margin (5.4% vs 2.9%, p=0.0093). Patients with PC experience worse overall and cancer specific survival than other types of recurrence (Figure).

Conclusions

PC occurred in almost 4% of our patients undergoing open RC. Worsening pathologic stage was associated with PC. Cancer death in patients with PC was almost universal at 5 years. Further analysis will be needed to determine risk factors for developing PC following RC.

Funding

none