Department of Urology, University of Michigan, Ann Arbor, MI; Department of Urology, Ohio State Wexner Medical Center, Columbus, OH.
Department of Internal Medicine, Division of Hematology/Oncology, University of Michigan, Ann Arbor, MI.
Urology. 2022 Sep;167:171-178. doi: 10.1016/j.urology.2022.04.002. Epub 2022 Apr 25.
To aid in the diagnosis and treatment of patients with metastatic tumor seeding, an exceedingly rare phenomenon following minimally invasive urological surgery, additional case reports are needed.
We report our experience with patients determined to have peritoneal carcinomatosis following robotic-assisted radical prostatectomy (RARP) and provide a descriptive summary of these unique cases.
Five cases of peritoneal carcinomatosis were identified, all of which occurred relatively late-between 8 and 13 years-following RARP. Four of the 5 cases had T3 disease at the time of prostatectomy. Ga-PSMA PET identified peritoneal carcinomatosis in 3 of 5 cases.
Certain clinical factors, such as advanced pathologic stage at the time of prostatectomy, may predict risk for carcinomatosis following RARP. Additionally, next-generation imaging modalities, such as PSMA PET, may aid in identifying these metastases and are likely to identify increasing numbers of these patients as next-generation imaging becomes more widely available. Continued documentation and classification of this atypical presentation are needed to improve our understanding and management of this phenomenon.
为了协助诊断和治疗微创泌尿外科手术后极为罕见的转移性肿瘤播散患者，需要更多的病例报告。
我们报告了我们在机器人辅助根治性前列腺切除术（RARP）后确定为腹膜癌病患者的经验，并对这些独特病例进行了描述性总结。
发现 5 例腹膜癌病，均发生在 RARP 后 8 至 13 年之间，相对较晚。5 例中有 4 例在前列腺切除时为 T3 期疾病。5 例中有 3 例 Ga-PSMA PET 发现腹膜癌病。
某些临床因素，如前列腺切除时的晚期病理分期，可能预示着 RARP 后发生癌病的风险。此外，下一代成像方式，如 PSMA PET，可能有助于识别这些转移灶，并且随着下一代成像变得更加广泛可用，可能会发现越来越多的这类患者。为了提高我们对这一现象的理解和管理，需要继续对这种非典型表现进行记录和分类。
