Perioperative and Long-term Oncological Outcomes of Patients with Muscle Invasive Bladder Cancer Who Underwent Radical Cystectomy—a Single-Center Experience

• Published in: Indian journal of surgery 2023-04, Vol.85 (2), p.280-287
• Main Authors: Chen, Zhi-Hao, Tseng, Wen-Hsin, Huang, Steven K., Liu, Chien-Liang, Hun, Shun-Hsing, Wang, Jhih-Cheng, Chiu, Allen W.
• Format: Article
• Language: English
• Subjects: Bladder cancer; Cancer; Cancer patients; Cardiac Surgery; Medicine; Medicine & Public Health; Mortality; Neurosurgery; Oncology, Experimental; Original Article; Patient outcomes; Pediatric Surgery; Plastic Surgery; Surgery; Thoracic Surgery
• ISSN: 0972-2068; 0973-9793
• DOI: 10.1007/s12262-022-03404-5

The current study aimed to report on the perioperative and long-term oncological outcomes of patients with muscle invasive bladder cancer who underwent radical cystectomy. Between January 2012 and December 2018, 207 patients were diagnosed with muscle invasive bladder cancer at our center, among whom 61 underwent radical cystectomy with a mean follow-up duration of 45.7 months. Postoperative complications were graded based on the Clavien–Dindo classification within 90 days after radical cystectomy. Disease-free survival and overall survival rates were determined according to tumor stage. Risk factors for perioperative complications, recurrence, and survival were assessed. The patients ( n  = 61) had a mean hospital stay of 20.9 days, with urinary diversion (23%), infection (18%), and blood transfusion (11.4%) being the most common complications following radical cystectomy. All complications were classified below Clavien–Dindo classification grade 3, most of which were controlled by conservative treatment. Re-operation within 90 days was required in 7 patients (11.5%) for enterolysis or cystorrhaphy, with no reported mortality after radical cystectomy. Carefully selected patients who underwent radical cystectomy, especially those with a Charlson Comorbidity Index of 0, 1, and 2 and clinical stage of T2 and T3, demonstrated better oncological outcomes compared to those who underwent trimodal therapy. The current study showed that adequately selected patients who underwent radical cystectomy had better oncological outcome compared to those who underwent trimodal therapy. The risk factors for perioperative complications included diabetes mellitus, male sex, smoking habit, alcohol consumption, and betel nut consumption.