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. 2023 Jul;62(Suppl2):21-27.
doi: 10.20471/acc.2023.62.s2.3.

OPEN RADICAL CYSTECTOMY: SINGLE CENTER RESULTS AND OUTCOMES IN THE LAST FIVE YEARS

Bojan Čikić  1 , Toni Zekulić  1 , Luka Penezić  1 , Jerko Anđelić  1 , Tomislav Kuliš  1   2 , Hrvoje Saić  1 , Ahmad El-Saleh  1 , Vedran Andrijašević  1 , Tvrtko Hudolin  1   2 , Eleonora Goluža  2   3 , Željko Kaštelan  1   2
Affiliations

OPEN RADICAL CYSTECTOMY: SINGLE CENTER RESULTS AND OUTCOMES IN THE LAST FIVE YEARS

Bojan Čikić et al. Acta Clin Croat. 2023 Jul.

Abstract

Radical cystectomy is a therapeutic modality of choice for many patients with muscle-invasive bladder cancer. We conducted a retrospective study of open radical cystectomies performed at a single Center from January 2017 to January 2022. Decision on the urinary diversion type was based on tumor stage, comorbidities, patient age, general condition and preferences. There were 19.5% of female and 80.5% of male patients, median age 67 (range 38-90) years. We performed 96 (44.7%) ureterocutaneostomies (UCS), 67 (31.2%) ileal conduit derivations, and 52 (24.2%) orthotopic neobladder derivations (OND). There were 17 (7.9%) complications after UCS, 7 (3.2%) after incontinent urinary diversion, and 7 (3.2%) after OND. Fifty-five (25.6%) patients developed early complications, of which 31 (14.4%) during the initial hospitalization period, and 24 (11.2%) required re-hospitalization in the 30-day postoperative period. The most common wound-related complication was wound dehiscence, most typically caused by infection. The main reason for readmission was urosepsis. The 30-day mortality rate was 0.9%. Late complications that occurred 30 days after the operation were found in 39 (18.1%) cases. Bladder cancer is a high-mortality disease that requires a multidisciplinary and personalized approach. Further development of multidisciplinary teams, perioperative and postoperative care, and follow-up strategy is needed to improve the oncologic and functional outcomes of this procedure.

Keywords: Bladder cancer; Cystectomy; Ileal conduit; Survival; Urinary diversion.

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Figures

Fig. 1
Fig. 1
Urinary diversion types. UCS = ureterocutaneostomy
Fig. 2a
Fig. 2a
Kaplan-Meier curve of survival depending on urinary diversion.
Fig. 2b
Fig. 2b
Kaplan-Meier curve of overall survival. UCS = ureterocutaneostomy
Fig. 3
Fig. 3
Different derivations according to the stage of disease. OND = orthotopic neobladder derivation; UCS = ureterocutaneostomy; T = tumor stage
See this image and copyright information in PMC

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