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Urinary diversion after cystectomy for bladder cancer: A population-based study in Sweden

Jahnson, Staffan ; Damm, Ole ; Hellsten, Sverker LU ; Holmang, Sten ; Liedberg, Fredrik LU ; Ljungberg, Borje ; Malmstrom, Per-Uno ; Månsson, Wiking LU ; Rosell, Johan and Wijkstom, Hans (2010) In Scandinavian Journal of Urology and Nephrology 44(2). p.69-75
Abstract
Objective. To investigate the type of urinary diversion performed after cystectomy in patients with muscle-invasive bladder cancer in Sweden, using data from a population-based national register. Material and methods. Since 1997, the Swedish Bladder Cancer Register has included more than 90% of all patients with newly diagnosed bladder cancer. The different types of urinary diversion performed in 1997-2003 were analysed, comparing non-continent diversion (ileal conduit) with continent reconstruction (bladder substitution or continent cutaneous diversion). Results. During the study period, 3463 patients were registered with clinical T2-T4 non-metastatic bladder cancer. Cystectomy was performed in 1141 patients with ileal conduit in 732... (More)
Objective. To investigate the type of urinary diversion performed after cystectomy in patients with muscle-invasive bladder cancer in Sweden, using data from a population-based national register. Material and methods. Since 1997, the Swedish Bladder Cancer Register has included more than 90% of all patients with newly diagnosed bladder cancer. The different types of urinary diversion performed in 1997-2003 were analysed, comparing non-continent diversion (ileal conduit) with continent reconstruction (bladder substitution or continent cutaneous diversion). Results. During the study period, 3463 patients were registered with clinical T2-T4 non-metastatic bladder cancer. Cystectomy was performed in 1141 patients with ileal conduit in 732 (64%) and continent reconstruction in 409 (36%). Ileal conduit was used more frequently in females than males (p = 0.019), in patients older than 75 years (p < 0.00001), and in those with less favourable TNM classification. Continent reconstruction was done more often at university hospitals than at county hospitals (p < 0.00001), but rarely in the northern and western healthcare regions compared with other regions (p < 0.00001). Nationwide, the proportion of registered continent reconstructions decreased, although the absolute number was relatively stable (50-60 per year). Conclusions. Continent reconstruction after cystectomy for muscle-invasive bladder cancer is performed more often in some healthcare regions and in patients at university hospitals than in county hospitals, indicating a substantial provider influence on the choice of urinary diversion. Over time, the proportion of these procedures has decreased, while the absolute number has remained low and stable; therefore, concentration in high-volume hospitals specialized in bladder cancer and continent reconstruction seems appropriate. (Less)
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author
; ; ; ; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
urinary diversion, Bladder cancer, nationwide register
in
Scandinavian Journal of Urology and Nephrology
volume
44
issue
2
pages
69 - 75
publisher
Taylor & Francis
external identifiers
  • wos:000275894700001
  • scopus:77950216343
  • pmid:20001606
ISSN
0036-5599
DOI
10.3109/00365590903449357
language
English
LU publication?
yes
additional info
The information about affiliations in this record was updated in December 2015. The record was previously connected to the following departments: Department of Urology, Lund (013077000), Urology (013243400)
id
368353c3-949c-4cc1-840a-ee8108230fae (old id 1587250)
date added to LUP
2016-04-01 13:50:16
date last changed
2023-03-09 11:29:35
@article{368353c3-949c-4cc1-840a-ee8108230fae,
  abstract     = {{Objective. To investigate the type of urinary diversion performed after cystectomy in patients with muscle-invasive bladder cancer in Sweden, using data from a population-based national register. Material and methods. Since 1997, the Swedish Bladder Cancer Register has included more than 90% of all patients with newly diagnosed bladder cancer. The different types of urinary diversion performed in 1997-2003 were analysed, comparing non-continent diversion (ileal conduit) with continent reconstruction (bladder substitution or continent cutaneous diversion). Results. During the study period, 3463 patients were registered with clinical T2-T4 non-metastatic bladder cancer. Cystectomy was performed in 1141 patients with ileal conduit in 732 (64%) and continent reconstruction in 409 (36%). Ileal conduit was used more frequently in females than males (p = 0.019), in patients older than 75 years (p &lt; 0.00001), and in those with less favourable TNM classification. Continent reconstruction was done more often at university hospitals than at county hospitals (p &lt; 0.00001), but rarely in the northern and western healthcare regions compared with other regions (p &lt; 0.00001). Nationwide, the proportion of registered continent reconstructions decreased, although the absolute number was relatively stable (50-60 per year). Conclusions. Continent reconstruction after cystectomy for muscle-invasive bladder cancer is performed more often in some healthcare regions and in patients at university hospitals than in county hospitals, indicating a substantial provider influence on the choice of urinary diversion. Over time, the proportion of these procedures has decreased, while the absolute number has remained low and stable; therefore, concentration in high-volume hospitals specialized in bladder cancer and continent reconstruction seems appropriate.}},
  author       = {{Jahnson, Staffan and Damm, Ole and Hellsten, Sverker and Holmang, Sten and Liedberg, Fredrik and Ljungberg, Borje and Malmstrom, Per-Uno and Månsson, Wiking and Rosell, Johan and Wijkstom, Hans}},
  issn         = {{0036-5599}},
  keywords     = {{urinary diversion; Bladder cancer; nationwide register}},
  language     = {{eng}},
  number       = {{2}},
  pages        = {{69--75}},
  publisher    = {{Taylor & Francis}},
  series       = {{Scandinavian Journal of Urology and Nephrology}},
  title        = {{Urinary diversion after cystectomy for bladder cancer: A population-based study in Sweden}},
  url          = {{http://dx.doi.org/10.3109/00365590903449357}},
  doi          = {{10.3109/00365590903449357}},
  volume       = {{44}},
  year         = {{2010}},
}