Page 10 - CUA 2020_Onco_Testis-Kidney-Urothelial

2020 CUA Abstracts

MP-3.14. Table 2. Cause of death stratified by testicular histology
Non-seminoma Seminoma
Cause of death HR 95% CI p HR 95% CI p
Cardiovascular 4.46 2.10–9.43 <0.01 2.34 0.98–5.49 0.054
Other neoplasm 7.03 4.58–10.78 <0.01 7.38 4.53–12.06 <0.01
Infectious and parasitic 6.88 0.892–53.07 0.06 1.64 0.46–40.09 0.19
Respiratory 0.009 0–∞ 0.78 0.006 0–∞ 0.77
Genitourinary neoplasm 10.29 4.24–24.94 <0.01 5.2 1.87–14.43 <0.01

MP-3.15
Robotic retroperitoneal lymph node dissection for primary and
MP-3.14. Table 3. Sensitivity analysis for cause of death post-chemotherapy testis cancer
Cause of death Testis Demographic Histology Gregory Nason , Kopika Kuhathaas , Lynn Anson-Cartwright , Michael A.
1
1
1
cancer variable Jewett , Martin O’Malley , Joan Sweet , Aaron Hansen , Philippe Bedard ,
2
1
3
4
4
5
5
5
Cardiovascular 0.517 1.047 0.469 Peter Chung , Ezra Hahn , Padraig Warde , Robert J. Hamilton 1 2
1
(p<0.01) Seminoma: 0.998 Urology, Princess Margaret Cancer Centre, Toronto, ON, Canada; Joint
Non-seminoma: 2.11 Department of Medical Imaging, University Health Network, Toronto,
3
ON, Canada; Laboratory Medicine and Pathobiology, University Health
(p<0.01) Network, Toronto, ON, Canada; Medical Oncology, Princess Margaret
4
Any neoplasm 0.96 1.51 (p<0.01) 0.178 (p<0.01) Cancer Centre, Toronto, ON, Canada; Radiation Oncology, Princess
5
Non-seminoma: 7.03 Margaret Cancer Centre, Toronto, ON, Canada
(p< 0.05) Introduction: The role of retroperitoneal lymph node dissection (RPLND)
Seminoma: 7.39 in testicular cancer is well-established. Minimally invasive approaches
(p<0.01) have had limited adoption. Robotic RPLND has evolved, but to date,
Infectious and 1.27 1.92 (p<0.05) 0.325 only small series have reported outcomes, with analyses hampered by
disproportionate inclusion of early-stage disease and the impact of adju-
parasitic Non-seminoma: 6.88 vant chemotherapy. Herein, we report the first 25 robotic RPLND cases
Seminoma: 4.31 performed in Canada.
Respiratory 0.040 0.843 107.1 Methods: A retrospective review was performed of all patients undergoing
(p<0.05) Non-seminoma: 0.009 robotic RPLND, which were performed by a single surgeon at Princess
Seminoma: 0.006 Margaret Cancer Centre. Demographic, perioperative, and oncological
data were analyzed using descriptive statistics.
Genitourinary 1.816 3.308 0.474 Results: Between September 2014 and October 2019, 25 patients under-
neoplasm (p<0.01) (p<0.01) Non-seminoma: 10.29 went a robotic RPLND, 17 (68%) were primary and eight (32%) post-
(p<0.01) chemotherapy. Stage at RPLND was 2A (56%), 2B (32%), 2C (4%), and 3A
Seminoma: 5.20 (8%). Median operating room time (incision to closure) was 510 minutes
(p<0.01) (range 180–600) and median blood loss was 200 ml (range 50–6000).
Nerve-sparing was performed in all but one case (96%). Six (24%) adju-
vant procedures were performed, including two (8%) vascular repairs and
3. Haugnes HS, Wethal T, Aass N, et al. Cardiovascular risk factors and two cases were converted to open (one for bleeding and other for rapid
morbidity in long-term survivors of testicular cancer: A 20-year fol- progression from preoperative computed tomography CT). Median length
lowup study. J Clin Oncol 2010;28:4649-57. https://doi.org/10.1200/ of stay was two days (range 1–8). Viable tumour was detected in 16 (64%),
JCO.2010.29.9362 teratoma in eight (32%), and fibrosis/necrosis in only one (4%). Median
4. Travis LB, Fosså SD, Schonfeld SJ, et al. Second cancers among followup was 20 months (range 1–52). Three patients (12%) relapsed:
40 576 testicular cancer patients: Focus on long-term survivors. JNCI one brain, one retrocrural, and one combined in- and out-of-field retro-
J Natl Cancer Inst 2005;97:1354-65. https://doi.org/10.1093/jnci/ peritoneal relapse 21 months post-RPLND for a seminoma. Two of three
dji278 received chemo, while the brain relapse was treated with radiation alone.
5. van Den Belt-Dusebout AW, Nuver J, de Wit R, et al. Long-term risk of Conclusions: Robotic RPLND can be performed safely. A long-term fol-
cardiovascular disease in 5-year survivors of testicular cancer. J Clin lowup of series such as ours, enriched with patients with viable disease
Oncol 2006;24:467-75. https://doi.org/10.1200/JCO.2005.02.7193 and/or teratoma, and not treated with adjuvant chemotherapy, is required
to ensure oncological outcomes are comparable to the open approach.

S96 CUAJ • June 2020 • Volume 14, Issue 6(Suppl2)
CUAJ • June 2020 • Volume 14, Issue 6(Suppl2)