Prostate Cancer With Peritoneal Carcinomatosis: A Robotic-assisted Radical Prostatectomy-based Case Series

Urology. 2022 Sep:167:171-178. doi: 10.1016/j.urology.2022.04.002. Epub 2022 Apr 25.

Abstract

Objective: 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.

Materials and methods: 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.

Results: 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. 68Ga-PSMA PET identified peritoneal carcinomatosis in 3 of 5 cases.

Conclusion: 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.

MeSH terms

  • Gallium Isotopes
  • Gallium Radioisotopes
  • Humans
  • Male
  • Peritoneal Neoplasms* / diagnosis
  • Peritoneal Neoplasms* / etiology
  • Peritoneal Neoplasms* / surgery
  • Prostatectomy / methods
  • Prostatic Neoplasms* / pathology
  • Robotic Surgical Procedures* / methods
  • Treatment Outcome

Substances

  • Gallium Isotopes
  • Gallium Radioisotopes
  • gallium 68 PSMA-11