ASSOCIATION BETWEEN RISK FACTORS AND COMPLICATIONS IN RADICAL CYSTECTOMY PATIENTS

NA SHAIKH; J KUMAR; SA AHMED; I ALBEERDY; W KUMAR; A HAFEEZ

doi:10.54112/bcsrj.v2023i1.366

Authors

NA SHAIKH Department of Urology, DGH NHS Foundation Trust, Dudley, West Midlands, United Kingdom
J KUMAR Department of Urology, The Indus Hospital Karachi, Pakistan
SA AHMED Department of Urology, Shoukat Khanam Memorial Cancer Hospital Lahore, Pakistan
I ALBEERDY Department of Urology, Sindh Institute of Urology and Transplantation (SIUT), Pakistan
W KUMAR Department of Urology Indus Hospital Karachi, Pakistan
A HAFEEZ Department of Urology Indus Hospital Karachi, Pakistan

DOI:

https://doi.org/10.54112/bcsrj.v2023i1.366

Keywords:

Risk Factors, Complications, Chronic kidney disease, Radical Cystectomy

Abstract

Radical cystectomy is considered first-line management in patients with muscle-invasive bladder cancer, and since radical cystectomy is associated with a high rate of complications, a comprehensive study to evaluate risk factors for this surgery is of utmost importance to optimize the treatment to the patient. In this single-center, retrospective cohort study, patients admitted for a Radical cystectomy from July 2016 to December 2019 had their demographics, lab parameters, and outcomes recorded. The study included 36 patients, of which 31(86%) were males. There was no significant association between gender, smoking status, comorbid, ASA score, and presence of CKD, pre-op hydronephrosis, and lymph node status. However, patients with pre-op serum albumin ≤3.5 had 7.8 times higher odds of post-op complications than those with pre-op serum albumin >3.5, adjusting for chronic kidney disease. The p-value was statistically significant (p=0.03). Only low serum albumin was statistically associated with poor outcomes. Other factors studied were not significantly associated with an adverse result. There is still much controversy regarding the risk factors that increase the risk of complications after RC; as such, more studies are needed to establish them in the RC setting fully.

Downloads

Download data is not yet available.

References

Abrahamyan, L., Petrosyan, V., and Crape, B. Risk Factors Associated With Postoperative Complications Following Radical Cystectomy.

Allaire, J., Ben-Zvi, T., Lamarche, B., Robitaille, K., Fradet, Y., Lacombe, L., and Fradet, V. J. C. U. A. J. (2017). Preoperative nutritional factors and outcomes after radical cystectomy: A narrative review. 11, 419.

Bagrodia, A., Grover, S., Srivastava, A., Gupta, A., Bolenz, C., Sagalowsky, A. I., and Lotan, Y. (2009). Impact of body mass index on clinical and cost outcomes after radical cystectomy. BJU international 104, 326-330.

Bhalla, R. G., Wang, L., Chang, S. S., and Tyson, M. D. J. T. J. o. u. (2017). Association between preoperative albumin levels and length of stay after radical cystectomy. 198, 1039-1045.

Chan, E., Yip, S., Hou, S., Cheung, H., Lee, W., and Ng, C. J. H. K. M. J. (2013). Age, tumour stage, and preoperative serum albumin level are independent predictors of mortality after radical cystectomy for treatment of bladder cancer in Hong Kong Chinese. 19, 400-406.

Chromecki, T. F., Cha, E. K., Fajkovic, H., Rink, M., Ehdaie, B., Svatek, R. S., Karakiewicz, P. I., Lotan, Y., Tilki, D., and Bastian, P. J. J. B. i. (2013). Obesity is associated with worse oncological outcomes in patients treated with radical cystectomy. 111, 249-255.

D'Elia, C., Comploj, E., Cerruto, M. A., Trenti, E., Palermo, S. M., Melotti, R., Artibani, W., and Pycha, A. J. U. i. (2017). 90-day mortality after radical cystectomy for bladder cancer: prognostic factors in a multicenter case series. 98, 255-261.

Furrer, M. A., Schneider, M. P., Burkhard, F. C., and Wuethrich, P. Y. (2018). Incidence and perioperative risk factors for early acute kidney injury after radical cystectomy and urinary diversion. In "Urologic Oncology: Seminars and Original Investigations", Vol. 36, pp. 306. e17-306. e23. Elsevier.

Gandaglia, G., Varda, B., Sood, A., Pucheril, D., Konijeti, R., Sammon, J. D., Sukumar, S., Menon, M., Sun, M., and Chang, S. L. J. C. U. A. J. (2014). Short-term perioperative outcomes of patients treated with radical cystectomy for bladder cancer included in the National Surgical Quality Improvement Program (NSQIP) database. 8, E681.

Garg, T., Chen, L. Y., Kim, P. H., Zhao, P. T., Herr, H. W., and Donat, S. M. J. B. i. (2014). Preoperative serum albumin is associated with mortality and complications after radical cystectomy. 113, 918-923.

Gierth, M., Zeman, F., Denzinger, S., Vetterlein, M. W., Fisch, M., Bastian, P. J., Syring, I., Ellinger, J., Müller, S. C., and Herrmann, E. J. U. i. (2018). Influence of body mass index on clinical outcome parameters, complication rate and survival after radical cystectomy: evidence from a prospective European multicentre study. 101, 16-24.

Hamano, I., Hatakeyama, S., Iwamurau, H., Fujita, N., Fukushi, K., Narita, T., Hagiwara, K., Kusaka, A., Hosogoe, S., and Yamamoto, H. J. O. (2017). Preoperative chronic kidney disease predicts poor oncological outcomes after radical cystectomy in patients with muscle-invasive bladder cancer. 8, 61404.

Hautmann, R. E., de Petriconi, R. C., and Volkmer, B. G. (2010). Lessons learned from 1,000 neobladders: the 90-day complication rate. The Journal of urology 184, 990-994.

Hirobe, M., Tanaka, T., Shindo, T., Ichihara, K., Hotta, H., Takahashi, A., Kato, R., Yanase, M., Matsukawa, M., and Itoh, N. J. I. j. o. c. o. (2018). Complications within 90 days after radical cystectomy for bladder cancer: results of a multicenter prospective study in Japan. 23, 734-741.

Hollenbeck, B. K., Miller, D. C., Taub, D., Dunn, R. L., Khuri, S. F., Henderson, W. G., Montie, J. E., UNDERWOOD III, W., and Wei, J. T. (2005). Identifying risk factors for potentially avoidable complications following radical cystectomy. The Journal of urology 174, 1231-1237.

Janković, S., and Radosavljević, V. (2007). Risk factors for bladder cancer. Tumori Journal 93, 4-12.

Johnson, D. C., Riggs, S. B., Nielsen, M. E., Matthews, J. E., Woods, M. E., Wallen, E. M., Pruthi, R. S., and Smith, A. B. J. W. j. o. u. (2015). Nutritional predictors of complications following radical cystectomy. 33, 1129-1137.

Lavallée, L. T., Schramm, D., Witiuk, K., Mallick, R., Fergusson, D., Morash, C., Cagiannos, I., and Breau, R. H. J. P. O. (2014). Peri-operative morbidity associated with radical cystectomy in a multicenter database of community and academic hospitals. 9.

Lenardis, M., Harper, B., Satkunasivam, R., Klaassen, Z., and Wallis, C. J. C. U. A. J. (2020). The association between patient body mass index and perioperative outcomes following radical cystectomy: An analysis using the American College of Surgeons National Surgical Quality Improvement Program database. 14.

Lyon, T. D., Boorjian, S. A., Shah, P. H., Tarrell, R., Cheville, J. C., Frank, I., Karnes, R. J., Thompson, R. H., and Tollefson, M. K. (2019). Comprehensive characterization of perioperative reoperation following radical cystectomy. In "Urologic Oncology: Seminars and Original Investigations", Vol. 37, pp. 292. e11-292. e17. Elsevier.

Mannas, M. P., Lee, T., Forbes, C. M., Hong, T., Bisaillon, A., Gleave, M. E., So, A. I., Mayson, K., and Black, P. C. J. W. j. o. u. (2019). Predicting complications following radical cystectomy with the ACS NSQIP universal surgical risk calculator. 1-6.

Marques Bernardino, R., Severo, L., Andrade, V., Fernandes, F., Falcao, G., and Campos Pinheiro, L. (2018). What are the main predictors of post-operatory complications after radical cystectomy and urinary diversion?

Morgan, T. M., Keegan, K. A., Barocas, D. A., Ruhotina, N., Phillips, S. E., Chang, S. S., Penson, D. F., Clark, P. E., Smith, J. A., and Cookson, M. S. J. T. J. o. u. (2011). Predicting the probability of 90-day survival of elderly patients with bladder cancer treated with radical cystectomy. 186, 829-834.

Ornaghi, P. I., Afferi, L., Antonelli, A., Cerruto, M. A., Odorizzi, K., Gozzo, A., Mordasini, L., Mattei, A., Baumeister, P., and Cornelius, J. J. W. J. o. U. (2020). The impact of preoperative nutritional status on post‑surgical complication and mortality rates in patients undergoing radical cystectomy for bladder cancer: a systematic review of the literature.

Peng, L., Li, J., Cao, D., Ren, Z., Wei, T., You, C., Cheng, B., Wei, Q., Li, Y. J. J. o. C. R., and Oncology, C. (2020). Can robotic-assisted radical cystectomy provide patients with a smaller trauma and faster recovery period? A systematic review and meta-analysis of comparative trials. 1-11.

Ploeg, M., Aben, K. K., and Kiemeney, L. A. (2009). The present and future burden of urinary bladder cancer in the world. World journal of urology 27, 289-293.

Pycha, A., Comploj, E., Martini, T., Trenti, E., Mian, C., Lusuardi, L., Lodde, M., Mian, M., and Palermo, S. (2008). Comparison of complications in three incontinent urinary diversions. European urology 54, 825-834.

Reese, S. W., Ji, E., Paciotti, M., Leow, J. J., Mahvi, D. A., Steele, G., Urman, R. D., Whang, E. E., Kibel, A. S., and Mossanen, M. (2019). Risk factors and reasons for reoperation after radical cystectomy. In "Urologic Oncology: Seminars and Original Investigations". Elsevier.

Sathianathen, N. J., Weight, C. J., Jarosek, S. L., and Konety, B. R. J. B. C. (2018). Increased surgical complications in smokers undergoing radical cystectomy. 4, 403-409.

Schulz, G. B., Grimm, T., Buchner, A., Jokisch, F., Kretschmer, A., Casuscelli, J., Ziegelmüller, B., Stief, C. G., and Karl, A. J. C. g. c. (2018). Surgical high-risk patients with ASA≥ 3 undergoing radical cystectomy: morbidity, mortality, and predictors for major complications in a high-volume tertiary center. 16, e1141-e1149.

Sefik, E., Celik, S., Gunlusoy, B., Basmaci, I., Bozkurt, I. H., and Degirmenci, T. J. I. B. J. U. (2020). The significance of preoperative estimated glomerular filtration rate on survival outcomes in patients who underwent radical cystectomy and non-continent urinary diversion _. 46, 566-74.

Sood, A., Kachroo, N., Abdollah, F., Sammon, J. D., Löppenberg, B., Jindal, T., Sun, M., Trinh, Q.-D., Menon, M., and Peabody, J. O. J. U. (2017). An evaluation of the timing of surgical complications following radical cystectomy: data from the American College of Surgeons National Surgical Quality Improvement Program. 103, 91-98.

Sopori, M. J. N. R. I. (2002). Effects of cigarette smoke on the immune system. 2, 372-377.

Stimson, C., Chang, S. S., Barocas, D. A., Humphrey, J. E., Patel, S. G., Clark, P. E., Smith Jr, J. A., and Cookson, M. S. (2010). Early and late perioperative outcomes following radical cystectomy: 90-day readmissions, morbidity and mortality in a contemporary series. The Journal of urology 184, 1296-1300.