Robot-assisted laparoscopic radical prostatectomy is one of the treatment options for localized prostate cancer, with an excellent disease control rate. However, these patients can experience late disease recurrence with metastatic dissemination. Peritoneal metastases are an uncommon recurrence site. Here, we discuss 3 cases of peritoneal metastases following robot-assisted laparoscopic radical prostatectomy and the mechanisms of peritoneal invasion. Through a literature review and our case reports, we postulate the existence of 2 distinct mechanisms of peritoneal invasion: one being iatrogenic, following a laparoscopic surgery with a well differentiated prostate cancer at a nonadvanced stage of the disease, the other involving the natural course of poor-prognosis tumors, even without surgery.
