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Robotic Assisted Surgical Approach for Genitourinary Tract Malignancies: State of...
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Robotic Assisted Surgical Approach for Genitourinary Tract Malignancies: State of the Art

A special issue of Cancers (ISSN 2072-6694). This special issue belongs to the section "Methods and Technologies Development".

Deadline for manuscript submissions: closed (31 December 2024) | Viewed by 6275

Special Issue Editors

Dr. Giuseppe Simone

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Guest Editor
Department of Urologic Oncology, IRCCS “Regina Elena” National Cancer Institute, Rome, Italy
Interests: robotics; laparoscopy; prostate cancer; renal cancer; bladder cancer
Special Issues, Collections and Topics in MDPI journals
Dr. Alfredo Bove

E-Mail
Guest Editor
IRCCS Regina Elena National Cancer Institute, Rome, Italy
Interests: renal cancer; bladder cancer; prostate cancer; penile cancer; robotic surgery; oncology

Special Issue Information

Dear Colleagues,

The robotic-assisted approach brought undeniable advantages in terms of peri-operative and functional outcomes, to patients affected by genitourinary malignancies scheduled for surgery, without compromising their oncologic outcomes. As such, all radical prostatectomies and most radical/partial nephrectomies are performed, nowadays, with the application of a robotic surgical system.

The Robotic assisted approach is progressively becoming the standard of care also for adrenal malignancies as well as bladder cancer treatment (although results from recent randomized-controlled trials comparing robot-assisted vs. open approach are still controversial). Notably, the adoption of robotic approach reduced the high mobility tightly related to inguinal lymph node management in patients affected by penile cancer.

This Special Issue reflects the state of the art of robotic approaches for genitourinary malignancies.

Potential topics include but are not limited to, the following: robotic prostatectomy, robotic partial nephrectomy, robotic cystectomy, robotic nephroureterectomy, robotic adrenalectomy, robotic inguinal lymphadenectomy for penile cancer, robotic approach to complications resulting from uro-oncologic treatments. Robotic resection of adrenal metastases.

Dr. Giuseppe Simone
Dr. Alfredo Bove
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Cancers is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • robotics
  • urology
  • uro-oncology
  • surgery
  • minimally invasive surgery

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Published Papers (3 papers)

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Research

10 pages, 393 KiB  
Article
Assessing Trifecta and Pentafecta Success Rates between Robot-Assisted vs. Open Radical Cystectomy: A Propensity Score-Matched Analysis
by Filippo Gavi, Nazario Foschi, Daniele Fettucciari, Pierluigi Russo, Diana Giannarelli, Mauro Ragonese, Carlo Gandi, Giovanni Balocchi, Alessandra Francocci, Francesco Pio Bizzarri, Filippo Marino, Giovanni Battista Filomena, Giuseppe Palermo, Angelo Totaro, Marco Racioppi, Riccardo Bientinesi and Emilio Sacco
Cancers 2024, 16(7), 1270; https://doi.org/10.3390/cancers16071270 - 25 Mar 2024
Cited by 3 | Viewed by 1559
Abstract
Background: This study aimed to evaluate the surgical and oncological outcomes of robot-assisted radical cystectomy (RARC) versus open radical cystectomy (ORC) using trifecta and pentafecta parameters. Methods: The clinical data of 41 patients who underwent RARC between 2018 and 2022 were prospectively collected [...] Read more.
Background: This study aimed to evaluate the surgical and oncological outcomes of robot-assisted radical cystectomy (RARC) versus open radical cystectomy (ORC) using trifecta and pentafecta parameters. Methods: The clinical data of 41 patients who underwent RARC between 2018 and 2022 were prospectively collected and retrospectively compared to those of 330 patients undergoing ORC using 1:1 propensity score matching. Trifecta was defined as simultaneous negative surgical margins (SMs), a lymph node (LN) yield ≥ 16, and the absence of major complications (Clavien–Dindo grade III–V) within 90 days postoperatively. Pentafecta additionally included a 12-month recurrence-free rate and a time between the transurethral resection of a bladder tumor (TURBT) and radical cystectomy (RC) ≤ 3 months. The continuous variables were compared using the Mann–Whitney U test, and the categorical variables were analyzed using the chi-squared test. Results: No statistically significant differences in trifecta and pentafecta success rates were observed between the RARC and ORC cohorts after propensity score matching. However, the RARC group exhibited significantly reduced blood loss (RARC: 317 mL vs. ORC: 525 mL, p = 0.01). Conclusions: RARC offers distinct advantages over ORC in terms of reduced blood loss, while trifecta and pentafecta success rates do not differ significantly between the two surgical approaches. Full article
(This article belongs to the Special Issue Robotic Assisted Surgical Approach for Genitourinary Tract Malignancies: State of the Art)
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11 pages, 1161 KiB  
Article
Adrenalectomy for Metastasis: The Impact of Primary Histology on Survival Outcome
by Mariaconsiglia Ferriero, Andrea Iannuzzi, Alfredo Maria Bove, Gabriele Tuderti, Umberto Anceschi, Leonardo Misuraca, Aldo Brassetti, Riccardo Mastroianni, Salvatore Guaglianone, Costantino Leonardo, Rocco Papalia, Michele Gallucci and Giuseppe Simone
Cancers 2024, 16(4), 763; https://doi.org/10.3390/cancers16040763 - 13 Feb 2024
Cited by 2 | Viewed by 1842
Abstract
Adrenalectomy is commonly considered a curative treatment in case of adrenal gland as site of metastasis. In the present study, we evaluated the impact of primary tumor histology on survival outcomes after a minimally invasive adrenal mastectomy for a solitary metachronous metastasis. From [...] Read more.
Adrenalectomy is commonly considered a curative treatment in case of adrenal gland as site of metastasis. In the present study, we evaluated the impact of primary tumor histology on survival outcomes after a minimally invasive adrenal mastectomy for a solitary metachronous metastasis. From May 2004 to August 2020, we prospectively collected data on minimally invasive adrenalectomies whose pathological examination showed a metastasis. All patients only received metastasectomies that were performed with curative intent, or to achieve non-evidence of disease status. Adjuvant systemic therapy was not administered in any case. Cancer-specific survival (CSS) was assessed using the Kaplan–Meier method. Univariable and multivariable Cox regression analyses were applied to identify independent predictors of CSS. Out of 235 laparoscopic and robotic adrenalectomies, the pathologic report showed metastases in 60 cases. The primary histologies included 36 (60%) renal cell carcinoma (RCC), 9 (15%) lung cancer, 6 (10%) colon cancer, 4 (6.7%) sarcoma, 3 (5%) melanoma and 2 (3.3%) bladder cancer. RCC displayed significantly longer survival rates with a 5-year CSS of 55.9%, versus 22.8% for other histologies (log-rank p = 0.01). At univariable analysis, disease-free interval (defined as the time from adrenalectomy to evidence of disease progression) < 12 months and histology were predictors of CSS (p = 0.003 and p < 0.001, respectively). At multivariable Cox analysis, the only independent predictor of CSS was primary tumor histology (p = 0.005); patients with adrenal metastasis from colon cancer and bladder cancer showed a 5.3- and 75.5-fold increased risk of cancer death, respectively, compared to patients who had RCC as primary tumor histology. Oncological outcomes of adrenal metastasectomies are strongly influenced by primary tumor histology. A proper discussion of the role of surgery in a multidisciplinary context could provide optimal treatment strategies. Full article
(This article belongs to the Special Issue Robotic Assisted Surgical Approach for Genitourinary Tract Malignancies: State of the Art)
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10 pages, 836 KiB  
Article
The Impact of Metastasectomy on Survival Outcomes of Renal Cell Carcinoma: A 10-Year Single Center Experience
by Mariaconsiglia Ferriero, Loris Cacciatore, Mario Ochoa, Riccardo Mastroianni, Gabriele Tuderti, Manuela Costantini, Umberto Anceschi, Leonardo Misuraca, Aldo Brassetti, Salvatore Guaglianone, Alfredo Maria Bove, Rocco Papalia, Michele Gallucci and Giuseppe Simone
Cancers 2023, 15(13), 3332; https://doi.org/10.3390/cancers15133332 - 25 Jun 2023
Cited by 7 | Viewed by 2318
Abstract
Objectives: The role of surgical metastasectomy (MST) in solitary or oligometastasis from renal cell carcinoma (RCC) and its impact on survival outcomes remains poorly addressed. We evaluated the impact of MST on overall survival (OS) in patients with oligometastatic (m)RCC. Materials and methods: [...] Read more.
Objectives: The role of surgical metastasectomy (MST) in solitary or oligometastasis from renal cell carcinoma (RCC) and its impact on survival outcomes remains poorly addressed. We evaluated the impact of MST on overall survival (OS) in patients with oligometastatic (m)RCC. Materials and methods: The institutional renal cancer prospective database was examined for cases treated with partial or radical nephrectomy who developed metastatic disease during follow-up. Patients with evidence of clinical metastasis at first diagnosis were excluded. Patients considered unfit for MST received systemic treatment (ST); all others received MST. The impact of MST vs. the ST only cohort was assessed with the Kaplan–Meier method. Age, gender, bilaterality, histology, AJCC stage of primary tumor, surgical margins, local vs. distant metastasis and MST were included in univariable and multivariable regression analyses to assess the predictors of OS. Results: Overall, at a median follow-up of 16 months after primary treatment, 168 patients with RCC developed asynchronous metastasis at the adrenal gland, lung, liver, spleen, peritoneal, renal fossa, bone, nodes, brain and thyroid gland. Nine patients unfit for any treatment were excluded. The site of metastasis was treated with surgical MST (77/159, 48.4%), with or without previous or subsequent ST, while 82/159 cases (51.2%) received ST only. The 2-year, 5-year and 10-year OS probabilities were 93.8%, 82.8% and 79.5%, respectively. After multivariable analysis, MST and the primary tumor AJCC stage were independent predictors of OS probabilities (p = 0.019 and p = 0.035, respectively). After Kaplan–Meier analysis, MST significantly improved OS probabilities versus patients receiving ST (p < 0.001). Limitations: The main drawbacks of our research were the small sample size from a single-tertiary referral institution, as well as the absent or different ST lines in the cohort of patients receiving MST. Conclusions: When an NED status is achievable, surgical MST of mRCC significantly impacts OS, delaying and not precluding further subsequent ST. Full article
(This article belongs to the Special Issue Robotic Assisted Surgical Approach for Genitourinary Tract Malignancies: State of the Art)
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