Francesco Cantiello1, Antonio Cicione2, Riccardo Autorino3, Cosimo De Nunzio4, Andrea Salonia5, Alberto Briganti5, Antonio Aliberti2, Sisto Perdonà6, Andrea Tubaro4, Rocco Damiano2. 1. Urology Unit, Magna Graecia University of Catanzaro, Catanzaro, Italy; Doctorate Research Program, Magna Graecia University of Catanzaro, Catanzaro, Italy. Electronic address: cantiello@unicz.it. 2. Urology Unit, Magna Graecia University of Catanzaro, Catanzaro, Italy; Doctorate Research Program, Magna Graecia University of Catanzaro, Catanzaro, Italy. 3. Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, OH. 4. Department of Urology, La Sapienza University of Rome, S. Andrea Hospital, Rome, Italy. 5. Doctorate Research Program, Magna Graecia University of Catanzaro, Catanzaro, Italy; Urological Research Institute, University Vita-Salute San Raffaele, Milan, Italy. 6. Department of Urology, National Cancer Institute of Naples, Naples, Italy.
Abstract
INTRODUCTION/ BACKGROUND: The objective of this study was to evaluate the effect of MetS and its components on the early complications observed in patients treated with RC and urinary diversion. PATIENTS AND METHODS: We retrospectively analyzed 346 patients with bladder cancer undergoing RC with standard lymphadenectomy, according to the procedure suggested by the International Consultation on Bladder Cancer, and urinary diversion. All early complications within 90 days of surgery were recorded and collected according to the 10 Martin criteria and classified according to the established 5 grades of the modified Clavien classification system (CCS). MetS was defined according to the National Cholesterol Educational Program's Third Adult Treatment Panel. A binary logistic regression analysis was used to analyze MetS and, separately, its single components, as possible independent risk factors for high-grade complications. RESULTS: A total of 323 complications occurred in 231 of 346 patients (66.8%). The rates for low-grade (CCS I-II) and high-grade complications (CCS III-V), and mortality within 90 days (CCS V), were 80.8% (261 of 323), 19.2% (62 of 323), and 1.7% (6 of 346), respectively. At univariate analysis, MetS patients showed a higher rate of high-grade complications compared with patients without MetS (P < .001). At binary logistic regression analysis, MetS (OR, 1.3; P = .010), waist circumference (OR, 1.9; P = .022) and, only in single model, urinary diversion (OR, 1.3; P = .024) were independent risk factors for high-grade complications. CONCLUSION: RC is a major surgical procedure with a significant early complications rate, nevertheless, most are low-grade complications. MetS and, separately, waist circumference are associated with high-grade complications.
INTRODUCTION/ BACKGROUND: The objective of this study was to evaluate the effect of MetS and its components on the early complications observed in patients treated with RC and urinary diversion. PATIENTS AND METHODS: We retrospectively analyzed 346 patients with bladder cancer undergoing RC with standard lymphadenectomy, according to the procedure suggested by the International Consultation on Bladder Cancer, and urinary diversion. All early complications within 90 days of surgery were recorded and collected according to the 10 Martin criteria and classified according to the established 5 grades of the modified Clavien classification system (CCS). MetS was defined according to the National Cholesterol Educational Program's Third Adult Treatment Panel. A binary logistic regression analysis was used to analyze MetS and, separately, its single components, as possible independent risk factors for high-grade complications. RESULTS: A total of 323 complications occurred in 231 of 346 patients (66.8%). The rates for low-grade (CCS I-II) and high-grade complications (CCS III-V), and mortality within 90 days (CCS V), were 80.8% (261 of 323), 19.2% (62 of 323), and 1.7% (6 of 346), respectively. At univariate analysis, MetSpatients showed a higher rate of high-grade complications compared with patients without MetS (P < .001). At binary logistic regression analysis, MetS (OR, 1.3; P = .010), waist circumference (OR, 1.9; P = .022) and, only in single model, urinary diversion (OR, 1.3; P = .024) were independent risk factors for high-grade complications. CONCLUSION: RC is a major surgical procedure with a significant early complications rate, nevertheless, most are low-grade complications. MetS and, separately, waist circumference are associated with high-grade complications.
Authors: Alban Zarzavadjian Le Bian; David Fuks; Sophie Chopinet; Sébastien Gaujoux; Manuela Cesaretti; Renato Costi; Ajay P Belgaumkar; Claude Smadja; Brice Gayet Journal: World J Gastroenterol Date: 2017-05-07 Impact factor: 5.742
Authors: Sophia Liff Maibom; Ulla Nordström Joensen; Alicia Martin Poulsen; Henrik Kehlet; Klaus Brasso; Martin Andreas Røder Journal: BMJ Open Date: 2021-04-14 Impact factor: 2.692
Authors: Amanda Leiter; John Doucette; Susan Krege; Chia-Chia Lin; Noah Hahn; Thorsten Ecke; Guru Sonpavde; Aristotle Bamias; William K Oh; Matthew D Galsky Journal: Bladder Cancer Date: 2016-07-27