OBJECTIVE: To report the temporal changes in peri-operative outcome over an extended period in patients undergoing radical cystectomy (RC) for all causes, irrespective of the previous treatment or pathology; and to establish a current standard of peri-operative outcome for RC by analysis of contemporary operative mortality rates (2000-5) factored for risk factors that might predict outcome. PATIENTS AND METHODS: All patients undergoing RC between 1970 and 2005 were analysed; this was an unselected single-centre series and included patients previously treated by definitive radiotherapy, chemotherapy, and cases of RC where the primary tumour involved the bladder but was not of bladder origin. RESULTS: In all, 846 patients had a RC, of whom 647 had a bladder primary tumour and 199 a primary tumour elsewhere (gynaecological, colorectal and others). There was a progressive reduction in 30- and 60-day mortality rates, such that the current peri-operative mortality (1999-2005) was 0.4% and 2.6%, respectively. There was a significant reduction in the re-operation rate over the decades (P=0.01), which is currently 4.7%. Patient age was a significant factor in 30- and 60-day mortality rates (P<0.001 for both) but there was no significant association between either American Society of Anesthesiologists grade or T stage with complication rates (P=0.61 and 0.12, respectively). CONCLUSION: There has been a progressive reduction in mortality related to RC, associated with both cases of RC and pelvic exenteration. The contemporary standard for 30-and 60-day mortality rates for these operations is 0.4% and 2.6%, respectively.
OBJECTIVE: To report the temporal changes in peri-operative outcome over an extended period in patients undergoing radical cystectomy (RC) for all causes, irrespective of the previous treatment or pathology; and to establish a current standard of peri-operative outcome for RC by analysis of contemporary operative mortality rates (2000-5) factored for risk factors that might predict outcome. PATIENTS AND METHODS: All patients undergoing RC between 1970 and 2005 were analysed; this was an unselected single-centre series and included patients previously treated by definitive radiotherapy, chemotherapy, and cases of RC where the primary tumour involved the bladder but was not of bladder origin. RESULTS: In all, 846 patients had a RC, of whom 647 had a bladder primary tumour and 199 a primary tumour elsewhere (gynaecological, colorectal and others). There was a progressive reduction in 30- and 60-day mortality rates, such that the current peri-operative mortality (1999-2005) was 0.4% and 2.6%, respectively. There was a significant reduction in the re-operation rate over the decades (P=0.01), which is currently 4.7%. Patient age was a significant factor in 30- and 60-day mortality rates (P<0.001 for both) but there was no significant association between either American Society of Anesthesiologists grade or T stage with complication rates (P=0.61 and 0.12, respectively). CONCLUSION: There has been a progressive reduction in mortality related to RC, associated with both cases of RC and pelvic exenteration. The contemporary standard for 30-and 60-day mortality rates for these operations is 0.4% and 2.6%, respectively.
Authors: Yun-Sok Ha; Chunri Yan; Pildu Jeong; Won Tae Kim; Seok-Joong Yun; Isaac Yi Kim; Sung-Kwon Moon; Wun-Jae Kim Journal: J Korean Med Sci Date: 2011-01-24 Impact factor: 2.153
Authors: Jens Mani; Stefan Vallo; Maximilian P Brandt; Kilian M Gust; Claudia Bartsch; Johannes Daechert; Igor Tsaur; Georg Bartsch; Axel Haferkamp Journal: Patient Prefer Adherence Date: 2016-10-28 Impact factor: 2.711