Advanced

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

Jahnson, Staffan; Damm, Ole; Hellsten, Sverker LU ; Holmang, Sten; Liedberg, Fredrik; Ljungberg, Borje; Malmstrom, Per-Uno; Månsson, Wiking LU ; Rosell, Johan and Wijkstom, Hans (2010) In Scandinavian Journal of Urology and Nephrology1967-01-01+01:002013-01-01+01:00 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)
Please use this url to cite or link to this publication:
author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
urinary diversion, Bladder cancer, nationwide register
in
Scandinavian Journal of Urology and Nephrology1967-01-01+01:002013-01-01+01:00
volume
44
issue
2
pages
69 - 75
publisher
Taylor & Francis
external identifiers
  • wos:000275894700001
  • scopus:77950216343
ISSN
0036-5599
DOI
10.3109/00365590903449357
language
English
LU publication?
yes
id
368353c3-949c-4cc1-840a-ee8108230fae (old id 1587250)
date added to LUP
2010-04-22 15:45:44
date last changed
2018-05-29 11:34:25
@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},
  keyword      = {urinary diversion,Bladder cancer,nationwide register},
  language     = {eng},
  number       = {2},
  pages        = {69--75},
  publisher    = {Taylor & Francis},
  series       = {Scandinavian Journal of Urology and Nephrology1967-01-01+01:002013-01-01+01:00},
  title        = {Urinary diversion after cystectomy for bladder cancer: A population-based study in Sweden},
  url          = {http://dx.doi.org/10.3109/00365590903449357},
  volume       = {44},
  year         = {2010},
}