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Long-term follow-up after radical cystectomy with emphasis on complications and reoperations: a Swedish population-based survey.
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2012 (English)In: Scandinavian Journal of Urology and Nephrology, ISSN 0036-5599, E-ISSN 1651-2065, Vol. 46, no 1, 14-8 p.Article in journal (Refereed) Published
Abstract [en]

OBJECTIVE: To evaluate outcome after radical cystectomy for primary bladder cancer in a large population-based material.

MATERIAL AND METHODS: Between 1997 and 2002 all patients treated with radical cystectomy within 3 months after diagnosis of primary bladder cancer without distant metastasis were retrieved through the Swedish Bladder Cancer Registry. A follow-up questionnaire was distributed to all units where the primary registration of patients was performed. Follow-up data on recurrence date were retrieved from the patient charts and causes of death were obtained from the Swedish Cause of Death Registry until 2003.

RESULTS: During the study period radical cystectomy was performed in 39 units in Sweden, of which only five units were considered high-volume hospitals performing 10 or more procedures annually. Mean blood loss was 2300 ml (median 2000 ml) and the 90-day mortality rate was 5.7%. Blood loss was higher in high-volume units than in hospitals with lower hospital volumes, but the 90-day mortality rates were similar. During a median follow-up of 3.5 years, 24% of the patients were submitted to a reoperation. Reoperation rates were significantly higher in patients who received a continent urinary diversion (29%) compared with an ileal conduit (22%, p < 0.015).

CONCLUSIONS: Radical cystectomy was associated with a reoperation rate of 24% in Sweden during the study period. The reoperation rates were higher in patients receiving a continent cutaneous diversion or bladder substitution. Blood loss was higher in high-volume units; otherwise, surgical volume did not affect mortality rates, cancer-specific survival or reoperation rates.

Place, publisher, year, edition, pages
2012. Vol. 46, no 1, 14-8 p.
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Urology and Nephrology
URN: urn:nbn:se:umu:diva-107603DOI: 10.3109/00365599.2011.609835PubMedID: 21854101OAI: diva2:848433
Available from: 2015-08-25 Created: 2015-08-25 Last updated: 2015-08-25

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Ljungberg, Börje
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