Complications and Mortality After Radical Cystectomy for Bladder Transitional Cell Cancer

Abstract

When applying a standardized methodology to report early morbidity, about 50% of patients undergoing radical cystectomy had complications within 3 months of surgery. Although most complications were minor, about 13% of patients experienced grade 3 to 5 events, resulting in a 3-month mortality rate of 3%. American Society of Anesthesiologists score was significantly associated with major complications, while on subgroup analysis in patients who received an orthotopic ileal neobladder female gender was also an independent predictor of major complications.

Systematic Review and Cumulative Analysis of Perioperative Outcomes and Complications After Robot-assisted Radical Cystectomy

“…These outcomes have been reported extensively for ORC, including reports using standardized Martin criteria. In general, ORC is associated with a high risk of complications (>60%), including a considerable risk of high-grade complications (13-40% in large series) and mortality (up to 7% in some series) [101][102][103][104][105]. ORC outcomes appear to be associated with hospital and surgeon experience and volumes, with several studies demonstrating improved performance in high-volume centers by high-volume surgeons [106,107].…”

Short-term perioperative outcomes of patients treated with radical cystectomy for bladder cancer included in the National Surgical Quality Improvement Program (NSQIP) database

“…However, previous studies failed to show higher complication rates for advanced diseases compared to localized tumours. 2,3,5,7 Nonetheless, further investigations are needed to comprehensively address this issue. Additionally, the NSQIP database lacked information regarding gastrointestinal complications, which has been shown to occur in a substantial proportion of patients after RC.…”

“…Additionally, the NSQIP database lacked information regarding gastrointestinal complications, which has been shown to occur in a substantial proportion of patients after RC. 2,3,10,20 Nonetheless, the NSQIP data has been shown to reliably identify those complications that are most predictive of mortality. The lack of data beyond 30 days is another limitation.…”

“…1 Despite refinements in surgical technique and perioperative management, RC has been associated with a substantial risk of postoperative morbidity and mortality, where the rates of short-term complications and mortality. [1][2][3][4][5][6][7] Identifying determinants of postoperative outcomes is crucial for individual risk-adjustment prior to RC. Several studies have reported predictors of complications, perioperative mortality, and readmission.…”

412 Identification of Underserved Areas for Urologic Cancer Care

“…Complication rates after RC range from 31% to 67%, and approximately one-third of patients are readmitted within the first 30 days after surgery. [43][44][45][46] The orchestration of this complex care is likely prohibitively time-consuming for providers in small groups or those in remote locations with limited resources.…”