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Scand J Urol Nephrol. 2012 Feb;46(1):14-8. doi: 10.3109/00365599.2011.609835. Epub 2011 Aug 19.

Long-term follow-up after radical cystectomy with emphasis on complications and reoperations: a Swedish population-based survey.

Author information

1
Department of Urology, Växjö County Hospital, Växjö, Sweden. f.liedberg@telia.com

Abstract

OBJECTIVE:

To evaluate outcome after radical cystectomy for primary bladder cancer in a large population-based material.

MATERIAL AND METHODS:

Between 1997 and 2002 all patients treated with radical cystectomy within 3 months after diagnosis of primary bladder cancer without distant metastasis were retrieved through the Swedish Bladder Cancer Registry. A follow-up questionnaire was distributed to all units where the primary registration of patients was performed. Follow-up data on recurrence date were retrieved from the patient charts and causes of death were obtained from the Swedish Cause of Death Registry until 2003.

RESULTS:

During the study period radical cystectomy was performed in 39 units in Sweden, of which only five units were considered high-volume hospitals performing 10 or more procedures annually. Mean blood loss was 2300 ml (median 2000 ml) and the 90-day mortality rate was 5.7%. Blood loss was higher in high-volume units than in hospitals with lower hospital volumes, but the 90-day mortality rates were similar. During a median follow-up of 3.5 years, 24% of the patients were submitted to a reoperation. Reoperation rates were significantly higher in patients who received a continent urinary diversion (29%) compared with an ileal conduit (22%, p < 0.015).

CONCLUSIONS:

Radical cystectomy was associated with a reoperation rate of 24% in Sweden during the study period. The reoperation rates were higher in patients receiving a continent cutaneous diversion or bladder substitution. Blood loss was higher in high-volume units; otherwise, surgical volume did not affect mortality rates, cancer-specific survival or reoperation rates.

PMID:
21854101
DOI:
10.3109/00365599.2011.609835
[Indexed for MEDLINE]

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