https://doi.org/10.4081/aiua.2021.4.379

Is it possible to reduce the complications and mortality of patients undergoing radical cystectomy? Effectiveness of pre-operative parameters. A prospective study

Vol. 93 No. 4 (2021)
Submitted: July 28, 2021
Accepted: September 9, 2021
Published: December 20, 2021
Albumin, bladder cancer, complications, cystectomy, mortality
Abstract Views: 1105
PDF: 418
Publisher's note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.

Authors

Övünç Kavukoglu
Department of Urology, University of Health Sciences, Kartal Dr. Lutfi Kırdar City Hospital, Istanbul, Turkey.
Alper Coskun
alpercoskun62@yahoo.com
Department of Urology, University of Health Sciences, Kartal Dr. Lutfi Kırdar City Hospital, Istanbul, Turkey.
Kubilay Sabuncu
https://orcid.org/0000-0002-1905-0302
Department of Urology, University of Health Sciences, Kartal Dr. Lutfi Kırdar City Hospital, Istanbul, Turkey.
Emre Çamur
Department of Urology, University of Health Sciences, Kartal Dr. Lutfi Kırdar City Hospital, Istanbul, Turkey.
Gökhan Faydaci
Department of Urology, University of Health Sciences, Kartal Dr. Lutfi Kırdar City Hospital, Istanbul, Turkey.

Objective: To evaluate the relationship between serum albumin, hematocrit (HTC), age-dependent Charlson comorbidity index, body mass index (BMI), and deleted operation time in predicting mortality and complications associated with radical cystectomy.
Materials and methods: All patients planned for radical cystectomy owing to bladder cancer were investigated prospectively between 2015 and 2016 in our clinic. A total of 55 cases were included in the study. Patients' characteristics, preoperative serum albumin values, hematocrit level, age-dependent Charlson comorbidity index (CCI), body mass index and deleted operation time, drainage catheter time, gas-stool expulsion time were recorded. The patients were followed up for 90 days.
Results: Age of cases, Charlson comorbidity index scores, and HCT were not different in patients with or without complications (overall) or severe complications nor in patients who died or survived after the procedure. The albumin value of the cases with observed mortality and complications was significantly lower than that of the cases with no mortality and complications. In multivariate and univariate analysis, low albumin level was established to be meaningful in predicting mortality and serious complications. The cut-off point for albumin, according to mortality, was found to be 4.1. Mortality within 90 days was 16.3% (n = 9).
Conclusions: We have evaluated albumin as a marker that could indicate both mortality and the presence of severe complications after radical cystectomy and urinary diversion.

Dimensions

Altmetric

PlumX Metrics

Downloads

Download data is not yet available.

Citations

Crossref
Scopus
Google Scholar
Europe PMC
Babjuk M, Böhle A, Burger M, et al. EAU Guidelines on non-muscle-invasive urothelial carcinoma of the bladder: update 2016. Eur Urol. 2017; 71:447-461. DOI: https://doi.org/10.1016/j.eururo.2016.05.041
Prout GR, Marshall VF. The prognosis with untreated bladder tumors. Cancer. 1956; 9:551-558. DOI: https://doi.org/10.1002/1097-0142(195605/06)9:3<551::AID-CNCR2820090319>3.0.CO;2-2
Lawrentschuk N, Colombo R, Hakenberg OW, et al. Prevention and management of complications following radical cystectomy for bladder cancer. Eur Urol. 2010; 57:983-1001. DOI: https://doi.org/10.1016/j.eururo.2010.02.024
Meyer JP, Blick C, Arumainayagam N, et al. A three-centre experience of orthotopic neobladder reconstruction after radical cystectomy: revisiting the initial experience, and results in 104 patients. BJU Int. 2009; 103:680-683. DOI: https://doi.org/10.1111/j.1464-410X.2008.08204.x
Morris DS, Weizer AZ, Ye Z, et al. Understanding bladder cancer death: tumor biology versus physician practice. Cancer. 2009;115:1011-1020. DOI: https://doi.org/10.1002/cncr.24136
Shabsigh A, Korets R, Vora KC, et al. Defining early morbidity of radical cystectomy for patients with bladder cancer using a standardized reporting methodology. Eur Urol. 2009; 55:164-74. DOI: https://doi.org/10.1016/j.eururo.2008.07.031
Novara G, Marco VD, Aragona M, et al. Complications and mortality after radical cystectomy for bladder transitional cell cancer. J Urol. 2009; 182:914-921. DOI: https://doi.org/10.1016/j.juro.2009.05.032
Bostrom PJ, Mirtti T, Kössi J, et al. Twenty-year experience of radical cystectomy for bladder cancer in a medium-volume centre. Scand J Urol Nephrol Suppl. 2009; 43:357-364. DOI: https://doi.org/10.3109/00365590902939387
Koppie TM, Serio AM, Vickers AJ, et al. Age-adjusted Charlson comorbidity score is associated with treatment decisions and clinical outcomes for patients undergoing radical cystectomy for bladder cancer. Cancer. 2008; 112:2384-2392. DOI: https://doi.org/10.1002/cncr.23462
Clavien PA, Sanabria JR, Strasberg SM. Proposed classification of complications of surgery with examples of utility in cholecystectomy. Surgery. 1992; 111:518-526.
Dindo D, Demartines N, Clavien PA. Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg. 2004; 240:205-213. DOI: https://doi.org/10.1097/01.sla.0000133083.54934.ae
Kim HL, Steinberg GD. Complications of cystectomy in patients with a history of pelvic radiation. Urology. 2001; 58:557-560. DOI: https://doi.org/10.1016/S0090-4295(01)01269-9
Mastroeni F, Aragona M, Caldarera E, et al. Deep venous thrombosis in patients undergoing salvage radical cystectomy. Arch Esp Urol. 2001; 54:839-841.
Arumainayagam N, McGrath J, Jefferson KP, Gillat DA. Introduction of an enhanced recovery protocol for radical cystectomy. BJU Int. 2008; 101:698-701. DOI: https://doi.org/10.1111/j.1464-410X.2007.07319.x
Charlson ME, Pompei P, Ales KL, MacKenzie CR. J Chronic Dis. 1987; 40:373-383. DOI: https://doi.org/10.1016/0021-9681(87)90171-8
Maffezzini M, Fontana V, Pacchetti A, et al. Age above 70 years and Charlson Comorbidity Index higher than 3 are associated with reduced survival probabilities after radical cystectomy for bladder cancer. Data from a contemporary series of 334 consecutive patients. Arch Ital Urol Androl. 2021; 93:15-20. DOI: https://doi.org/10.4081/aiua.2021.1.15
Frazier HA, Robertson JE, Paulson DF. Complications of radical cystectomy and urinary diversion: a retrospective review of 675 cases in 2 decades. J Urol. 1992; 148:1401-1405. DOI: https://doi.org/10.1016/S0022-5347(17)36921-5
Konety BR, Allareddy V, Herr H. Complications after radical cystectomy: analysis of population-based data. Urology. 2006; 68:58-64. DOI: https://doi.org/10.1016/j.urology.2006.01.051
Brannan W, Fuselier HA, Ochsner M, Randrup ER. Critical evaluation of 1-stage cystectomy--reducing morbidity and mortality. J Urol. 1981; 125:640-642. DOI: https://doi.org/10.1016/S0022-5347(17)55146-0
Skinner DG, Crawford ED, Kaufman JJ. Complications of radical cystectomy for carcinoma of the bladder. J Urol. 1980; 123:640-643. DOI: https://doi.org/10.1016/S0022-5347(17)56073-5
Gibbs J, Cull W, Henderson W, et al. Preoperative serum albumin level as a predictor of operative mortality and morbidity: results from the National VA Surgical Risk Study. Arch Surg. 1999;134:36-42. DOI: https://doi.org/10.1001/archsurg.134.1.36
Djaladat H, Bruins HM, Miranda G, et al. The association of preoperative serum albumin level and American Society of Anesthesiologists (ASA) score on early complications and survival of patients undergoing radical cystectomy for urothelial bladder cancer. BJU Int. 2014; 113:887-893. DOI: https://doi.org/10.1111/bju.12240
Gregg JR, Cookson MS, Phillips S, et al. Effect of preoperative nutritional deficiency on mortality after radical cystectomy for bladder cancer. J Urol. 2011; 185:90-96. DOI: https://doi.org/10.1016/j.juro.2010.09.021
Liu J, Dai Y, Zhou F, et al. The prognostic role of preoperative serum albumin/globulin ratio in patients with bladder urothelial carcinoma undergoing radical cystectomy. Urol Oncol. 2016; 34:484 e1-484e8. DOI: https://doi.org/10.1016/j.urolonc.2016.05.024
Gupta D, Lis CG. Pretreatment serum albumin as a predictor of cancer survival: a systematic review of the epidemiological literature. Nutr J. 2010; 9:69. DOI: https://doi.org/10.1186/1475-2891-9-69
Garg T, Chen LY, Donat M. Preoperative serum albumin is associated with mortality and complications after radical cystectomy. BJU Int. 2014; 113:918-923. DOI: https://doi.org/10.1111/bju.12405
Gore JL, Lai J, Setodji CM, et al. Mortality increases when radical cystectomy is delayed more than 12 weeks: results from a Surveillance, Epidemiology, and End Results-Medicare analysis. Cancer. 2009; 115:988-996. DOI: https://doi.org/10.1002/cncr.24052
Brennan MF, Pisters PW, Posner M, et al. A prospective randomized trial of total parenteral nutrition after major pancreatic resection for malignancy. Ann Surg. 1994; 220:436-444. DOI: https://doi.org/10.1097/00000658-199410000-00003

How to Cite

Kavukoglu Övünç ., Coskun, A. ., Sabuncu, K. ., Çamur, E., & Faydaci, G. . (2021). Is it possible to reduce the complications and mortality of patients undergoing radical cystectomy? Effectiveness of pre-operative parameters. A prospective study. Archivio Italiano Di Urologia E Andrologia, 93(4), 379–384. https://doi.org/10.4081/aiua.2021.4.379

PAGEPress has chosen to apply the Creative Commons Attribution NonCommercial 4.0 International License (CC BY-NC 4.0) to all manuscripts to be published.