Correlation between organ-specific co-morbidities and complications in bladder cancer patients undergoing radical cystectomy

Scand J Urol. 2018 Oct-Dec;52(5-6):395-400. doi: 10.1080/21681805.2018.1531921. Epub 2019 Jan 9.

Abstract

Objective: To evaluate the association between patients' organ-specific co-morbidities and post-operative complications following radical cystectomy for bladder cancer.

Patients and methods: All patients who underwent radical cystectomy at Aarhus University Hospital during the period from January 2006 to February 2014 were included retrospectively. A total of 40 comorbidities and 59 complications were registered meticulously. Univariate and multivariate analyses were used to detect associations between the individual comorbidities and specific post-operative complications.

Results: Ninety-two per cent (575/625) of patients experienced one or more complications following radical cystectomy. Clavien-Dindo grade 3-5 complications were observed in 40.8% of patients, and 6.2% had severe complications (Clavien-Dindo grade 4-5). The mortality rate was 2.2%. High BM, previous myocardial infarction and chronic obstructive pulmonary disease were noted to be associated with moderate-to-severe post-operative complications (Clavien-Dindo grade 3-5), while diabetes and lymphoproliferative disorders were significantly associated with severe complications (Clavien-Dindo grade 4-5).

Conclusion: This study demonstrates that overall complications to radical cystectomy are high (92%). The associations between specific comorbidities and complications need to be further investigated in order to evaluate whether pre-operative assessment can be more optimally used in a prevention strategy tailored to the individual patient.

Keywords: Bladder cancer; co-morbidities; complications; cystectomy.

MeSH terms

  • Adult
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Carcinoma, Transitional Cell / epidemiology
  • Carcinoma, Transitional Cell / surgery*
  • Cardiovascular Diseases / epidemiology
  • Comorbidity
  • Cystectomy / methods
  • Diabetes Mellitus, Type 2 / epidemiology*
  • Female
  • Humans
  • Hypertension / epidemiology
  • Lymphoproliferative Disorders / epidemiology*
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Myocardial Infarction / epidemiology*
  • Obesity / epidemiology*
  • Postoperative Complications / epidemiology*
  • Pulmonary Disease, Chronic Obstructive / epidemiology*
  • Renal Insufficiency, Chronic / epidemiology
  • Retrospective Studies
  • Salvage Therapy
  • Severity of Illness Index
  • Urinary Bladder Neoplasms / epidemiology
  • Urinary Bladder Neoplasms / surgery*
  • Urinary Diversion / statistics & numerical data