Complications Requiring Reoperation Common After Radical Cystectomy

Synchronous metastatic disease is characterized by the presence of metastatic lesions, in addition to the primary tumor, at diagnosis.
Synchronous metastatic disease is characterized by the presence of metastatic lesions, in addition to the primary tumor, at diagnosis.
A single-institution study revealed that 37% of patients who underwent radical cystectomy experienced at least 1 additional intervention.

Complications leading to reoperation are common following radical cystectomy, with more than one third of patients eventually requiring reoperation, according to data presented at the Society of Urologic Oncology’s 23rd annual meeting in San Diego, California.

Joshua Linscott, MD, PhD, a urology resident at Maine Medical Center in Portland, and colleagues identified 256 consecutive patients who underwent radical cystectomy for bladder cancer at a single institution from 2015 to 2022. The median follow-up was 19.1 months. Of the 256 patients, 95 (37.1%) had at least 1 additional intervention and 44 (17.2%) had multiple interventions. Most first interventions occurred within the first year.

On multivariable analysis, the investigators found that neobladder diversion was significantly associated with 3.3-fold greater odds of any additional intervention and 3.8-fold increased odds of urinary intervention. In addition, receiving neoadjuvant chemotherapy was significantly associated with 69% decreased odds of any additional intervention and urinary intervention.

The patients who experienced a post-RC event did not differ significantly in mean age from those who did not (69.5 vs 69.0 years), but they had a significantly higher mean body mass index (29.6 vs 27.4 kg/m2) and significantly longer mean operative time (389.7 vs 356.9 minutes).

The investigators concluded that their study findings demonstrate that patients with bladder cancer remain at high risk for reintervention for an extended period following radical cystectomy and should be counseled on their risks.

At the American Society of Nephrology’s Kidney Week 2022 conference in November, investigators reported study findings demonstrating that acute kidney injury and acute kidney disease are common complications of radical cystectomy. 

References

Linscott J, White RE, Hansen N, et al. Long term reoperation and complication risk after radical cystectomy. Presented at: SUO 2022, November 30-December 2, San Diego, California. Poster 1.

Trevisani F, Cinque A, Floris M, et al. AKI and acute kidney disease after radical cystectomy for muscle-invasive bladder cancer: A hidden uro-nephrological affair. Presented at: Kidney Week 2022; November 3-6, Orlando, Florida. Abstract TH-PO075.

This article originally appeared on Renal and Urology News