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Comparative Study
. 2014 Dec;21(6):7520-7.

Performance of partial cystectomy in the United States from 2001 to 2010: trends and comparative outcomes

Izak Faiena  1 , Viktor Dombrovskiy, Christopher Koprowski, Eric A Singer, Thomas L Jang, Robert E Weiss
Affiliations
Comparative Study

Performance of partial cystectomy in the United States from 2001 to 2010: trends and comparative outcomes

Izak Faiena et al. Can J Urol. 2014 Dec.

Abstract

Introduction: To investigate the trends in the performance of radical cystectomy (RC) versus partial cystectomy (PC) in the United States over the past 10 years and compare postoperative outcomes between two procedures.

Materials and methods: The data was captured from the Nationwide Inpatient Sample (NIS) 2001-2010 using the appropriate ICD-9-CM diagnosis and procedure codes. Patient sociodemographics, comorbidities and in-hospital complications after PC and RC were compared, taking into account some hospital characteristics. A chi-square analysis including a Cochran-Armitage trend test and a multivariable logistic regression analysis were employed.

Results: RC rate increased from 84.8% in 2001 to 90.3% in 2010, while PC decreased from 15.2% to 9.7% (p < 0.0001). PC patients were older than their RC counterparts (72.1 ± 11.3 versus 68.6 ± 10.1 years; p < 0.0001), had higher prevalence of major comorbidities, but decreased rate of postoperative complications overall (21.3% versus 38.6%; p < 0.001). The greatest rates of PC utilization were found in the Northeast and South (12.8% and 12.7%). The frequency of PC was 18.9% in non-teaching hospitals compared to 9.0% in teaching hospitals (p < 0.0001). In multivariate analysis, females, octogenarians, patients with hypertension and obesity, and patients in non-teaching and rural hospitals were more likely to receive PC.

Conclusions: Despite the potential advantages in cancer control offered by RC, PC is being performed more frequently on the elderly, female patients, patients with hypertension and obesity, in non-teaching and rural hospitals, and in certain United States geographic regions, which can be partially explained by disparities in access to high volume cancer centers.

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Figure 1
Figure 1
a. Trends in radical and partial cystectomy, United States 2001–2010. b. Trends in partial cystectomy utilization in various United States census regions, 2001–2010.
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