Defining Early Morbidity Of Radical Cystectomy For Patients With Bladder Cancer Using Standardized Reporting Methodology

Main Category: Urology / Nephrology
Also Included In: Cancer / Oncology
Article Date: 25 Aug 2008 - 1:00 PDT

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UroToday.com - This article, recently published in the online issue of European Urology, developed standard reporting methodology to define the type, incidence, and severity of early postoperative morbidities following radical cystectomy.

Between 1995 and 2005, 1142 consecutive radical cystectomy patients were entered into a prospective complication database and retrospectively reviewed for accuracy. All patients underwent RC/urinary diversion by high-volume fellowship-trained urologic oncologists. Complications were measured within the first 90 days of surgery Complications were defined and stratified into 11 specific categories. Using these categories, 64% of patients experienced a complication. Among patients experiencing a complication, 67% experienced a complication during the operative hospital admission and 58% following discharge. Eighty-seven percent of complications were grade 1 or 2 and did not require surgical intervention. Gastrointestinal complications were most common (29%), followed by infectious complications (25%) and wound-related complications (15%). The 30-day mortality rate was 1.5%.

These authors have helped define a consistent complication scoring system that will allow comparison across institutions. Surgical morbidity following radical cystectomy is significant and, when strict reporting guidelines are incorporated, higher than previously published. Accurate reporting of postoperative complications after RC is essential for counseling patients, combined modality treatment planning, clinical trial design, and assessment of surgical success.

Shabsigh A, Kurtas R, Vora KC, Brook CM, Cronin AM, Savage C, Raj G, Bochner BH, Dalbagni G, Herr HW, Donat SM
Eur Urol. 2008 Jul 18. Epub ahead of print.

Reported by UroToday.com Contributing Editor David P. Wood, MD

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