Effect of Neoadjuvant Chemotherapy on Complications, in-Hospital Mortality, Length of Stay and Total Hospital Costs in Bladder Cancer Patients Undergoing Radical Cystectomy

Background: To test for differences in complication rates, in-hospital mortality, length of stay (LOS) and total hospital costs (THCs) in patients treated with neoadjuvant chemotherapy (NAC) prior to radical cystectomy (RC). Methods: Within the National (Nationwide) Inpatient Sample (NIS) database (...

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Published in:Cancers 2022-02, Vol.14 (5), p.1222
Main Authors: Hoeh, Benedikt, Flammia, Rocco Simone, Hohenhorst, Lukas, Sorce, Gabriele, Chierigo, Francesco, Panunzio, Andrea, Tian, Zhe, Saad, Fred, Gallucci, Michele, Briganti, Alberto, Terrone, Carlo, Shariat, Shahrokh F, Graefen, Markus, Tilki, Derya, Antonelli, Alessandro, Kluth, Luis A, Mandel, Philipp, Chun, Felix K H, Karakiewicz, Pierre I
Format: Article
Language:English
Subjects:
Bladder cancer
Chemotherapy
Codes
Heart
Hospital costs
Invasiveness
Length of stay
Medicaid
Medicare
Metastases
Mortality
Patients
Regression analysis
Urinary bladder
Urothelial carcinoma
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Summary:Background: To test for differences in complication rates, in-hospital mortality, length of stay (LOS) and total hospital costs (THCs) in patients treated with neoadjuvant chemotherapy (NAC) prior to radical cystectomy (RC). Methods: Within the National (Nationwide) Inpatient Sample (NIS) database (2016−2019), we identified RC-treated, non-metastatic, lymph-node negative bladder cancer patients, stratified by NAC status. Trend analyses, multivariable logistic, multivariable Poisson and multivariable linear regression models were used. Results: We identified 4347 RC-treated bladder cancer patients. Of those, 805 (19%) received NAC prior to RC. Overall, complications rates did not differ (65 vs. 66%; p = 0.7). However, NAC patients harbored lower rates of surgical site (6 vs. 9%), cardiac (13 vs. 19%) and genitourinary (5.5 vs. 9.7%) complications. In-hospital mortality (
ISSN:2072-6694
2072-6694
DOI:10.3390/cancers14051222