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Cumulative incidence of ureteroenteric strictures after radical cystectomy in a population-based Swedish cohort

Magnusson, Jenny ; Hagberg, Oskar LU ; Aljabery, Firas ; Hosseini, Abolfazl ; Jahnson, Staffan ; Jerlström, Tomas ; Sherif, Amir ; Söderkvist, Karin ; Ströck, Viveka and Ullén, Anders , et al. (2021) In Scandinavian Journal of Urology 55(5). p.361-365
Abstract

Objective: The incidence of benign ureteroenteric strictures following radical cystectomy (RC) for urinary bladder cancer (UBC) is investigated mainly in single-centre studies from high-volume centres. The aim of this study was to evaluate the cumulative incidence of strictures and risk factors in a population-based cohort. Patients and methods: Data was collected from Bladder Cancer Data Base Sweden (BladderBaSe). The primary endpoint was stricture with intervention. Secondary endpoint included hydronephrosis both with/without intervention. Results: In total, 5,816 patients were registered as having had RC due to UBC between 1997 and 2014. After a median follow-up of 23.5 months (IQR = 9.0–63.1 months; range = 0.0–214.0 months), we... (More)

Objective: The incidence of benign ureteroenteric strictures following radical cystectomy (RC) for urinary bladder cancer (UBC) is investigated mainly in single-centre studies from high-volume centres. The aim of this study was to evaluate the cumulative incidence of strictures and risk factors in a population-based cohort. Patients and methods: Data was collected from Bladder Cancer Data Base Sweden (BladderBaSe). The primary endpoint was stricture with intervention. Secondary endpoint included hydronephrosis both with/without intervention. Results: In total, 5,816 patients were registered as having had RC due to UBC between 1997 and 2014. After a median follow-up of 23.5 months (IQR = 9.0–63.1 months; range = 0.0–214.0 months), we found that 515 (8.9%) patients underwent intervention for stricture. Seven hundred and sixty-one (13.1%) patients were diagnosed with hydronephrosis without intervention. The cumulative incidence of strictures with intervention was 19.7% (95% CI = 16.7–23.1%) during the 17 years of follow-up. In the first year, the cumulative incidence of strictures was 5.6% (95% CI = 5.0–6.2%), and in the first 2 years 8.4% (95% CI = 7.6–9.3%). For the secondary endpoint, the cumulative incidence was 30.4% (95% CI = 26.7–33.1%) after 17 years. Only the year of RC was associated with stricture incidence in Cox regression analysis, whereas hospital cystectomy volume, patient age and patient sex were not. Conclusion: Ureteroenteric strictures requiring intervention may be more common than previously reported, affecting nearly one fifth of patients who have undergone RC for UBC. The annual incidence was highest in the first 2 years after surgery but the cumulative incidence increased continuously during 17 years of follow-up.

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organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
bladder cancer, complications, population-based, radical cystectomy, ureteric stricture
in
Scandinavian Journal of Urology
volume
55
issue
5
pages
361 - 365
publisher
Taylor & Francis
external identifiers
  • pmid:34313191
  • scopus:85111700391
ISSN
2168-1805
DOI
10.1080/21681805.2021.1955967
language
English
LU publication?
yes
id
945f0caf-8de6-4275-a0db-74785c4b54df
date added to LUP
2021-08-30 15:31:26
date last changed
2024-02-20 11:15:34
@article{945f0caf-8de6-4275-a0db-74785c4b54df,
  abstract     = {{<p>Objective: The incidence of benign ureteroenteric strictures following radical cystectomy (RC) for urinary bladder cancer (UBC) is investigated mainly in single-centre studies from high-volume centres. The aim of this study was to evaluate the cumulative incidence of strictures and risk factors in a population-based cohort. Patients and methods: Data was collected from Bladder Cancer Data Base Sweden (BladderBaSe). The primary endpoint was stricture with intervention. Secondary endpoint included hydronephrosis both with/without intervention. Results: In total, 5,816 patients were registered as having had RC due to UBC between 1997 and 2014. After a median follow-up of 23.5 months (IQR = 9.0–63.1 months; range = 0.0–214.0 months), we found that 515 (8.9%) patients underwent intervention for stricture. Seven hundred and sixty-one (13.1%) patients were diagnosed with hydronephrosis without intervention. The cumulative incidence of strictures with intervention was 19.7% (95% CI = 16.7–23.1%) during the 17 years of follow-up. In the first year, the cumulative incidence of strictures was 5.6% (95% CI = 5.0–6.2%), and in the first 2 years 8.4% (95% CI = 7.6–9.3%). For the secondary endpoint, the cumulative incidence was 30.4% (95% CI = 26.7–33.1%) after 17 years. Only the year of RC was associated with stricture incidence in Cox regression analysis, whereas hospital cystectomy volume, patient age and patient sex were not. Conclusion: Ureteroenteric strictures requiring intervention may be more common than previously reported, affecting nearly one fifth of patients who have undergone RC for UBC. The annual incidence was highest in the first 2 years after surgery but the cumulative incidence increased continuously during 17 years of follow-up.</p>}},
  author       = {{Magnusson, Jenny and Hagberg, Oskar and Aljabery, Firas and Hosseini, Abolfazl and Jahnson, Staffan and Jerlström, Tomas and Sherif, Amir and Söderkvist, Karin and Ströck, Viveka and Ullén, Anders and Häggström, Christel and Holmberg, Lars and Kjölhede, Henrik}},
  issn         = {{2168-1805}},
  keywords     = {{bladder cancer; complications; population-based; radical cystectomy; ureteric stricture}},
  language     = {{eng}},
  number       = {{5}},
  pages        = {{361--365}},
  publisher    = {{Taylor & Francis}},
  series       = {{Scandinavian Journal of Urology}},
  title        = {{Cumulative incidence of ureteroenteric strictures after radical cystectomy in a population-based Swedish cohort}},
  url          = {{http://dx.doi.org/10.1080/21681805.2021.1955967}},
  doi          = {{10.1080/21681805.2021.1955967}},
  volume       = {{55}},
  year         = {{2021}},
}