Robot-assisted radical cystectomy for bladder cancer: single-center experience

Objective:Radical cystectomy remains the most effective treatment for patients with localized,invasive bladder cancer and recurrent noninvasive disease.Recently some surgeons have begun to describe outcomes associated with less invasive surgical approaches to this disease,such as laparoscopic or robotic assisted techniques.We report our maturing experience with 100 consecutive cases of robotic assisted laparoscopic radical cystectomy regarding perioperative results,pathological outcomes,and surgical complications.Methods:A total of 100 consecutive patients(73 male and 27 female)underwent robotic radical cystectomy with intracorporeal urinary diversion at our institution from February 2018 to February 2021 for clinically localized bladder cancer.Outcome measures evaluated included operative variables,hospital recovery,pathological outcomes,and complication rate.Results:The mean age of this cohort was 60.4 years(range 38 to 82).Ninety-five patients underwent ileal conduit diversion,5 received a neobladder).The mean operating room time for all patients was 184 min(min time was 160 min)and mean surgical blood loss was 286 ml.On surgical pathology,2%of the cases were pT1,35%were pT2,51+12%were pT3/T4 disease and 17%were node positive.The mean number of lymph nodes removed was 16(range 10 to 40).In no case was there a positive surgical margin.The mean days to flatus were 2.6,bowel movement 2.8 and discharge home 8.2.There were 21 postoperative complications in 20 patients with 4%having a major complication(Clavien grade 3 or higher)and 15%being readmitted within 30 days after surgery.At a mean follow-up of 12 months 3 patients had disease recurrence and died 4 of disease.Conclusions:We report a relatively large cohort and maturing experience with robotic radical cystectomy for the treatment of bladder cancer,providing acceptable surgical and pathological outcomes.These results support continued efforts to refine the surgical management of muscle-invasive bladder cancer.

PEP06 polypeptide 30 is a novel clusterdissociating agent inhibiting αv integrin/FAK/Src signaling in oral squamous cell carcinoma cells

Collectively migrating tumor cells have been recently implicated in enhanced metastasis of epithelial malignancies.In oral squamous cell carcinoma(OSCC),av integrin is a crucial mediator of multicellular clustering and collective movement in vitro;however,its contribution to metastatic spread remains to be addressed.According to the emerging therapeutic concept,dissociation of tumor clusters into single cells could significantly suppress metastasis-seeding ability of carcinomas.This study aimed to investigate the anti-OSCC potential of novel endostatin-derived polypeptide PEP06 as a clusterdissociating therapeutic agent in vitro.Firstly,we found marked enrichment ofαv integrin in collectivelyinvading multicellular clusters in human OSCCs.Our study revealed that metastatic progression of OSCC was associated with augmented immunostaining of av integrin in cancerous lesions.Following PEP06treatment,cell clustering on fibronectin,migration,multicellular aggregation,anchorage-independent survival and colony formation of OSCC were significantly inhibited.Moreover,PEP06 suppressed av integrin/FAK/Sre signaling in OSCC cells.PEP06-induced loss of active Src and E-cadherin from cell-cell contacts contributed to diminished collective migration of OSCC in vitro.Overall,these results suggest that PEP06 polypeptide 30 inhibiting av integrin/FAK/Src signaling and disrupting E-cadherin-based intercellular junctions possesses anti-metastatic potential in OSCC by acting as a cluster-dissociating therapeutic agent.