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Urinary bladder cancer treated with radical cystectomy: Perioperative parameters and early complications prospectively registered in a national population-based database

Jerlstrom, Tomas; Gardmark, Truls; Carringer, Malcolm; Holmang, Sten; Liedberg, Fredrik LU ; Hosseini, Abolfazl; Malmstrom, Per-Uno; Ljungberg, Borje; Hagberg, Oskar and Jahnson, Staffan (2014) In Scandinavian Journal of Urology2013-01-01+01:00 48(4). p.334-340
Abstract
Objective. Cystectomy combined with pelvic lymph-node dissection and urinary diversion entails high morbidity and mortality. Improvements are needed, and a first step is to collect information on the current situation. In 2011, this group took the initiative to start a population-based database in Sweden (population 9.5 million in 2011) with prospective registration of patients and complications until 90 days after cystectomy. This article reports findings from the first year of registration. Material and methods. Participation was voluntary, and data were reported by local urologists or research nurses. Perioperative parameters and early complications classified according to the modified Clavien system were registered, and selected... (More)
Objective. Cystectomy combined with pelvic lymph-node dissection and urinary diversion entails high morbidity and mortality. Improvements are needed, and a first step is to collect information on the current situation. In 2011, this group took the initiative to start a population-based database in Sweden (population 9.5 million in 2011) with prospective registration of patients and complications until 90 days after cystectomy. This article reports findings from the first year of registration. Material and methods. Participation was voluntary, and data were reported by local urologists or research nurses. Perioperative parameters and early complications classified according to the modified Clavien system were registered, and selected variables of possible importance for complications were analysed by univariate and multivariate logistic regression. Results. During 2011, 285 (65%) of 435 cystectomies performed in Sweden were registered in the database, the majority reported by the seven academic centres. Median blood loss was 1000 ml, operating time 318 min, and length of hospital stay 15 days. Any complications were registered for 103 patients (36%). Clavien grades 1-2 and 3-5 were noted in 19% and 15%, respectively. Thirty-seven patients (13%) were reoperated on at least once. In logistic regression analysis elevated risk of complications was significantly associated with operating time exceeding 318 min in both univariate and multivariate analysis, and with age 76-89 years only in multivariate analysis. Conclusions. It was feasible to start a national population-based registry of radical cystectomies for bladder cancer. The evaluation of the first year shows an increased risk of complications in patients with longer operating time and higher age. The results agree with some previously published series but should be interpreted with caution considering the relatively low coverage, which is expected to be higher in the future. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
bladder carcinoma, complications, radical cystectomy
in
Scandinavian Journal of Urology2013-01-01+01:00
volume
48
issue
4
pages
334 - 340
publisher
Taylor & Francis
external identifiers
  • wos:000340072700001
  • scopus:84904320467
ISSN
2168-1813
DOI
10.3109/21681805.2014.909883
language
English
LU publication?
yes
id
d2b529ab-5ef5-42ed-9dde-a9b04bc00d7b (old id 4659631)
date added to LUP
2014-10-01 07:22:23
date last changed
2017-10-22 03:27:14
@article{d2b529ab-5ef5-42ed-9dde-a9b04bc00d7b,
  abstract     = {Objective. Cystectomy combined with pelvic lymph-node dissection and urinary diversion entails high morbidity and mortality. Improvements are needed, and a first step is to collect information on the current situation. In 2011, this group took the initiative to start a population-based database in Sweden (population 9.5 million in 2011) with prospective registration of patients and complications until 90 days after cystectomy. This article reports findings from the first year of registration. Material and methods. Participation was voluntary, and data were reported by local urologists or research nurses. Perioperative parameters and early complications classified according to the modified Clavien system were registered, and selected variables of possible importance for complications were analysed by univariate and multivariate logistic regression. Results. During 2011, 285 (65%) of 435 cystectomies performed in Sweden were registered in the database, the majority reported by the seven academic centres. Median blood loss was 1000 ml, operating time 318 min, and length of hospital stay 15 days. Any complications were registered for 103 patients (36%). Clavien grades 1-2 and 3-5 were noted in 19% and 15%, respectively. Thirty-seven patients (13%) were reoperated on at least once. In logistic regression analysis elevated risk of complications was significantly associated with operating time exceeding 318 min in both univariate and multivariate analysis, and with age 76-89 years only in multivariate analysis. Conclusions. It was feasible to start a national population-based registry of radical cystectomies for bladder cancer. The evaluation of the first year shows an increased risk of complications in patients with longer operating time and higher age. The results agree with some previously published series but should be interpreted with caution considering the relatively low coverage, which is expected to be higher in the future.},
  author       = {Jerlstrom, Tomas and Gardmark, Truls and Carringer, Malcolm and Holmang, Sten and Liedberg, Fredrik and Hosseini, Abolfazl and Malmstrom, Per-Uno and Ljungberg, Borje and Hagberg, Oskar and Jahnson, Staffan},
  issn         = {2168-1813},
  keyword      = {bladder carcinoma,complications,radical cystectomy},
  language     = {eng},
  number       = {4},
  pages        = {334--340},
  publisher    = {Taylor & Francis},
  series       = {Scandinavian Journal of Urology2013-01-01+01:00},
  title        = {Urinary bladder cancer treated with radical cystectomy: Perioperative parameters and early complications prospectively registered in a national population-based database},
  url          = {http://dx.doi.org/10.3109/21681805.2014.909883},
  volume       = {48},
  year         = {2014},
}