1. Morbidity and mortality after robot-assisted radical cystectomy with intracorporeal urinary diversion in octogenarians: results from the European Association of Urology Robotic Urology Section Scientific Working Group
- Author
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Peter Wiklund, Hubert John, Carl Wijburg, Alessio Crippa, John D. Kelly, Erik Peder Rönmark, Abdullah Erdem Canda, S. Pokupić, Sebastian Edeling, Abolfazl Hosseini, Paolo Dell'Oglio, Frederiek D'Hondt, Wei Shen Tan, Christian Schwentner, Justin W. Collins, Ashkan Mortezavi, Alexandre Mottrie, Ashwin Sridhar, Karel Decaestecker, Francesco Montorsi, Canda, Abdullah Erdem (ORCID 0000-0002-5196-653X & YÖK ID 116202), Mortezavi, A., Crippa, A., Edeling, S., Pokupic, S., Dell'Oglio, P., Montorsi, F., D'Hondt, F., Mottrie, A, Decaestecker, K., Wijburg, C. J., Collins, J., Kelly, J. D., Tan, W. S., Sridhar, A., John, H., Schwentner, C., Rönmark, E. P., Wiklund, P., Hosseini, A., School of Medicine, Mortezavi, Ashkan, Crippa, Alessio, Edeling, Sebastian, Poupic, Sasa, Dell’Oglio, Paolo, Wijburg, Carl J., Collins, Justin, Kelly, John D., Tan, Wei Shen, Sridhar, Ashwin, John, Hubert, Schwentner, Christian, Rönmark, Erik Peder, Wiklund, Peder, and Hosseini, Abolfazl
- Subjects
Male ,#uroonc ,medicine.medical_treatment ,030232 urology & nephrology ,Urinary Diversion ,#blcsm ,Postoperative Complications ,0302 clinical medicine ,Robotic Surgical Procedures ,Risk Factors ,Medicine ,intracorporeal diversion ,Aged, 80 and over ,Mortality rate ,Urinary Reservoirs, Continent ,Age Factors ,#BladderCancer ,Middle Aged ,Europe ,Survival Rate ,030220 oncology & carcinogenesis ,bladder cancer ,Female ,Original Article ,medicine.medical_specialty ,Urology ,Operative Time ,complication ,Cystectomy ,#EndoUrology ,Perioperative Care ,robot‐assisted radical cystectomy ,03 medical and health sciences ,Humans ,Aged ,Proportional Hazards Models ,Retrospective Studies ,octogenarian ,Bladder cancer ,business.industry ,Robot-assisted radical cys tectomy ,Intracorporeal diversion ,Octogenarian ,Complication ,Mortality ,Blcsm ,Uroonc ,EndoUrology ,Urinary diversion ,Postoperative complication ,Odds ratio ,Original Articles ,medicine.disease ,mortality ,Confidence interval ,Urology and nephrology ,Surgery ,Urinary Bladder Neoplasms ,Robot?assisted ,Radical cystectomy ,Lymph Node Excision ,business - Abstract
Objectives: to evaluate the postoperative complication and mortality rate following laparoscopic radical cystectomy (RARC) with intracorporeal urinary diversion (ICUD) in octogenarians. Patients and methods: we conducted a retrospective analysis comparing postoperative complication and mortality rates depending on age in a consecutive series of 1890 patients who underwent RARC with ICUD for bladder cancer between 2004 and 2018 in 10 European centres. Outcomes of patients aged = 80 years were compared with regard to postoperative complications (Clavien-Dindo grading) and mortality rate. Cancer-specific mortality (CSM) and other-cause mortality (OCM) after surgery were calculated using the non-parametric Aalen-Johansen estimator. Results: a total of 1726 patients aged = 80 years were included in the analysis. The 30- and 90-day rate for high-grade (Clavien-Dindo grades III-V) complications were 15% and 21% for patients aged = 80 years (P = 0.2 and P = 0.03), respectively. In a multivariable logistic regression analysis adjusting for pre- and postoperative variables, age >= 80 years was not an independent predictor of high-grade complications (odds ratio 0.6, 95% confidence interval 0.3-1.1; P = 0.12). The non-cancer-related 90-day mortality was 2.3% for patients aged >= 80 years and 1.8% for those aged = 80 years, 15% and 8%, respectively (P = 0.009 and P < 0.001). Conclusions: the minimally invasive approach to RARC with ICUD for bladder cancer in well-selected elderly patients (aged >= 80 years) achieved a tolerable high-grade complication rate; the 90-day postoperative mortality rate was driven by cancer progression and the non-cancer-related rate was equivalent to that of patients aged, NA
- Published
- 2020