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Population-based analyses of radical cystectomy and urinary diversion for bladder cancer in northern Italy

2011; Wiley; Volume: 108; Issue: 8b Linguagem: Inglês

10.1111/j.1464-410x.2011.10095.x

1464-410X

Ugo Fedeli, Giacomo Novara, Claudia Galassi, Vincenzo Ficarra, Elena Schievano, Marco Gilardetti, Giovanni Muto, Oscar Bertetto, Giovannino Ciccone, Paolo Spolaore,

Urological Disorders and Treatments

BJU InternationalVolume 108, Issue 8b p. E266-E271 Population-based analyses of radical cystectomy and urinary diversion for bladder cancer in northern Italy Ugo Fedeli, Ugo Fedeli SER-Epidemiological Department, Veneto RegionSearch for more papers by this authorGiacomo Novara, Giacomo Novara Department of Oncological and Surgical Sciences, Urology Clinic, University of Padua, PaduaSearch for more papers by this authorClaudia Galassi, Claudia Galassi Center for Cancer Prevention, San Giovanni Battista University HospitalSearch for more papers by this authorVincenzo Ficarra, Corresponding Author Vincenzo Ficarra Department of Oncological and Surgical Sciences, Urology Clinic, University of Padua, PaduaVincenzo Ficarra, MD, Professor of Urology, Department of Oncological and Surgical Sciences, Urology Clinic, University of Padua, Monoblocco Ospedaliero, IV floor, Via Giustiniani 2, 35100 Padua, Italy. e-mail: [email protected]Search for more papers by this authorElena Schievano, Elena Schievano SER-Epidemiological Department, Veneto RegionSearch for more papers by this authorMarco Gilardetti, Marco Gilardetti Center for Cancer Prevention, San Giovanni Battista University HospitalSearch for more papers by this authorGiovanni Muto, Giovanni Muto Department of Urology, San Giovanni Bosco Hospital, TurinSearch for more papers by this authorOscar Bertetto, Oscar Bertetto AReSS – Agenzia Regionale per i Servizi Sanitari, Piedmont Region, ItalySearch for more papers by this authorGiovannino Ciccone, Giovannino Ciccone Center for Cancer Prevention, San Giovanni Battista University HospitalSearch for more papers by this authorPaolo Spolaore, Paolo Spolaore SER-Epidemiological Department, Veneto RegionSearch for more papers by this author Ugo Fedeli, Ugo Fedeli SER-Epidemiological Department, Veneto RegionSearch for more papers by this authorGiacomo Novara, Giacomo Novara Department of Oncological and Surgical Sciences, Urology Clinic, University of Padua, PaduaSearch for more papers by this authorClaudia Galassi, Claudia Galassi Center for Cancer Prevention, San Giovanni Battista University HospitalSearch for more papers by this authorVincenzo Ficarra, Corresponding Author Vincenzo Ficarra Department of Oncological and Surgical Sciences, Urology Clinic, University of Padua, PaduaVincenzo Ficarra, MD, Professor of Urology, Department of Oncological and Surgical Sciences, Urology Clinic, University of Padua, Monoblocco Ospedaliero, IV floor, Via Giustiniani 2, 35100 Padua, Italy. e-mail: [email protected]Search for more papers by this authorElena Schievano, Elena Schievano SER-Epidemiological Department, Veneto RegionSearch for more papers by this authorMarco Gilardetti, Marco Gilardetti Center for Cancer Prevention, San Giovanni Battista University HospitalSearch for more papers by this authorGiovanni Muto, Giovanni Muto Department of Urology, San Giovanni Bosco Hospital, TurinSearch for more papers by this authorOscar Bertetto, Oscar Bertetto AReSS – Agenzia Regionale per i Servizi Sanitari, Piedmont Region, ItalySearch for more papers by this authorGiovannino Ciccone, Giovannino Ciccone Center for Cancer Prevention, San Giovanni Battista University HospitalSearch for more papers by this authorPaolo Spolaore, Paolo Spolaore SER-Epidemiological Department, Veneto RegionSearch for more papers by this author First published: 14 February 2011 https://doi.org/10.1111/j.1464-410X.2011.10095.xCitations: 11Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat Abstract Study Type – Therapy (cohort) Level of Evidence 2b What’s known on the subject? and What does the study add? Published population-based data related to recourse to cystectomy, adoption of partial instead of radical cystectomy, determinants of perioperative mortality, complications and length of stay, pelvic lymphadenectomy, and type of urinary diversion, have been largely investigated in the USA, whereas evidence from Western and Southern Europe is lacking. This first population-based report on cystectomies for bladder cancer from continental Europe evidences a limited role of partial cystectomy, a high proportion of continent diversion, and a decreasing trend of length of stay and in-hospital mortality. OBJECTIVE • To provide updated figures on urinary diversion, length of stay and mortality after cystectomy in two regions of northern Italy. PATIENTS AND METHODS • Discharge records of patients undergoing cystectomy for bladder cancer in 2000–2008 were extracted from the regional archives of hospital discharges. • Data on partial vs radical cystectomy and type of urinary diversion were obtained from intervention codes. • The influence of demographic characteristics, year of intervention, presence of comorbidities and hospital cystectomy volume on the adoption of a continent diversion and on in-hospital mortality was assessed through multilevel models. RESULTS • The crude cystectomy rate was close to 10 per 100 000. • The share of partial cystectomies declined from 5.5% in 2000–2002 to 3.0% in 2006–2008. • A continent diversion was adopted in 35% of radical cystectomies, with higher rates in young male patients treated in high-volume hospitals. • Median length of stay declined from 20 days in 2000–2002 to 18 in 2006–2008; in-hospital mortality decreased from 3.2% to 2.2%. CONCLUSION • This first population-based report on cystectomies for bladder cancer from continental Europe evidences a limited role of partial cystectomy, a high proportion of continent diversion and a decreasing trend of length of stay and in-hospital mortality. Citing Literature Volume108, Issue8bOctober 2011Pages E266-E271 RelatedInformation