[Quality assessment of radical cystectomy-opportunities, risks, challenges]

Area of Science:

• Urology
• Oncology
• Surgical Quality Improvement

Background:

• Radical cystectomy (RC) is the standard treatment for muscle-invasive urothelial carcinoma.
• RC is associated with significant morbidity, mortality, and a 5-year overall survival rate of approximately 60%.

Purpose of the Study:

• To identify and summarize quality parameters for radical cystectomy.
• To categorize these parameters into early (for therapy planning) and long-term (for quality monitoring) criteria.

Main Methods:

• A PubMed search was conducted to identify relevant studies.
• Quality parameters were divided into oncological/functional criteria and freedom from complications.

Main Results:

• Early criteria include negative surgical margins, pelvic lymphadenectomy, continent urinary diversion, and sexual function preservation.
• Long-term criteria encompass absence of high-grade postoperative complications, recurrence-free survival, and health-related quality of life.

Conclusions:

• Early quality criteria aid in individualized therapy planning for radical cystectomy.
• Long-term criteria are essential for effective quality monitoring of radical cystectomy outcomes.