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Long-term follow-up after radical cystectomy with emphasis on complications and reoperations: A Swedish population-based survey

Liedberg, Fredrik; Holmberg, Erik; Holmang, Sten; Ljungberg, Borje; Malmstrom, Per-Uno; Månsson, Wiking LU ; Nunez, Leyla; Wessman, Catrin; Wijkstrom, Hans and Jahnson, Staffan (2012) In Scandinavian Journal of Urology and Nephrology1967-01-01+01:002013-01-01+01:00 46(1). p.14-18
Abstract
Objective. To evaluate outcome after radical cystectomy for primary bladder cancer in a large population-based material. Material and methods. Between 1997 and 2002 all patients treated with radical cystectomy within 3 months after diagnosis of primary bladder cancer without distant metastasis were retrieved through the Swedish Bladder Cancer Registry. A follow-up questionnaire was distributed to all units where the primary registration of patients was performed. Follow-up data on recurrence date were retrieved from the patient charts and causes of death were obtained from the Swedish Cause of Death Registry until 2003. Results. During the study period radical cystectomy was performed in 39 units in Sweden, of which only five units were... (More)
Objective. To evaluate outcome after radical cystectomy for primary bladder cancer in a large population-based material. Material and methods. Between 1997 and 2002 all patients treated with radical cystectomy within 3 months after diagnosis of primary bladder cancer without distant metastasis were retrieved through the Swedish Bladder Cancer Registry. A follow-up questionnaire was distributed to all units where the primary registration of patients was performed. Follow-up data on recurrence date were retrieved from the patient charts and causes of death were obtained from the Swedish Cause of Death Registry until 2003. Results. During the study period radical cystectomy was performed in 39 units in Sweden, of which only five units were considered high-volume hospitals performing 10 or more procedures annually. Mean blood loss was 2300 ml (median 2000 ml) and the 90-day mortality rate was 5.7%. Blood loss was higher in high-volume units than in hospitals with lower hospital volumes, but the 90-day mortality rates were similar. During a median follow-up of 3.5 years, 24% of the patients were submitted to a reoperation. Reoperation rates were significantly higher in patients who received a continent urinary diversion (29%) compared with an ileal conduit (22%, p < 0.015). Conclusions. Radical cystectomy was associated with a reoperation rate of 24% in Sweden during the study period. The reoperation rates were higher in patients receiving a continent cutaneous diversion or bladder substitution. Blood loss was higher in high-volume units; otherwise, surgical volume did not affect mortality rates, cancer-specific survival or reoperation rates. (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
bladder cancer, complications, radical cystectomy, reoperation
in
Scandinavian Journal of Urology and Nephrology1967-01-01+01:002013-01-01+01:00
volume
46
issue
1
pages
14 - 18
publisher
Taylor & Francis
external identifiers
  • wos:000299125800004
  • scopus:84856173589
ISSN
0036-5599
DOI
10.3109/00365599.2011.609835
language
English
LU publication?
yes
id
b9e4b24a-ec2d-4ae9-b042-1bc0e9367120 (old id 2355182)
date added to LUP
2012-03-01 11:27:06
date last changed
2017-10-22 04:04:30
@article{b9e4b24a-ec2d-4ae9-b042-1bc0e9367120,
  abstract     = {Objective. To evaluate outcome after radical cystectomy for primary bladder cancer in a large population-based material. Material and methods. Between 1997 and 2002 all patients treated with radical cystectomy within 3 months after diagnosis of primary bladder cancer without distant metastasis were retrieved through the Swedish Bladder Cancer Registry. A follow-up questionnaire was distributed to all units where the primary registration of patients was performed. Follow-up data on recurrence date were retrieved from the patient charts and causes of death were obtained from the Swedish Cause of Death Registry until 2003. Results. During the study period radical cystectomy was performed in 39 units in Sweden, of which only five units were considered high-volume hospitals performing 10 or more procedures annually. Mean blood loss was 2300 ml (median 2000 ml) and the 90-day mortality rate was 5.7%. Blood loss was higher in high-volume units than in hospitals with lower hospital volumes, but the 90-day mortality rates were similar. During a median follow-up of 3.5 years, 24% of the patients were submitted to a reoperation. Reoperation rates were significantly higher in patients who received a continent urinary diversion (29%) compared with an ileal conduit (22%, p &lt; 0.015). Conclusions. Radical cystectomy was associated with a reoperation rate of 24% in Sweden during the study period. The reoperation rates were higher in patients receiving a continent cutaneous diversion or bladder substitution. Blood loss was higher in high-volume units; otherwise, surgical volume did not affect mortality rates, cancer-specific survival or reoperation rates.},
  author       = {Liedberg, Fredrik and Holmberg, Erik and Holmang, Sten and Ljungberg, Borje and Malmstrom, Per-Uno and Månsson, Wiking and Nunez, Leyla and Wessman, Catrin and Wijkstrom, Hans and Jahnson, Staffan},
  issn         = {0036-5599},
  keyword      = {bladder cancer,complications,radical cystectomy,reoperation},
  language     = {eng},
  number       = {1},
  pages        = {14--18},
  publisher    = {Taylor & Francis},
  series       = {Scandinavian Journal of Urology and Nephrology1967-01-01+01:002013-01-01+01:00},
  title        = {Long-term follow-up after radical cystectomy with emphasis on complications and reoperations: A Swedish population-based survey},
  url          = {http://dx.doi.org/10.3109/00365599.2011.609835},
  volume       = {46},
  year         = {2012},
}