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The changing pattern of mortality and morbidity from radical cystectomy
D J Rosario1, M Becker, J B Anderson
1Department of Urology, Royal Hallamshire Hospital, Sheffield, UK.
BJU International
|February 26, 2000
Summary
Radical cystectomy has a low mortality rate (<2%) and reduced complications compared to historical data. Primary cystectomy is recommended for muscle-invasive bladder cancer, even in older patients.
Area of Science:
- Urology
- Surgical Oncology
Background:
- Radical cystectomy is a major surgical procedure for bladder cancer.
- Historical data suggests significant morbidity and mortality associated with this surgery.
Purpose of the Study:
- To evaluate the current morbidity and mortality rates of radical cystectomy.
- To compare contemporary outcomes with historical findings.
Main Methods:
- A consecutive series of 101 patients undergoing radical cystectomy were analyzed.
- Data collected included operative mortality, early and late complications, and postoperative stay.
- Patients undergoing salvage cystectomy after radiotherapy were specifically assessed.
Main Results:
- The study reported an operative mortality of less than 2%.
- Salvage cystectomy demonstrated significantly higher morbidity compared to primary cystectomy.
- Elderly patients (>70 years) did not experience higher mortality than younger age groups.
Conclusions:
- Current radical cystectomy practices show improved outcomes with lower mortality and morbidity.
- Primary cystectomy is the preferred treatment for muscle-invasive bladder cancer.
- Age should not be a contraindication for radical cystectomy.