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World Journal of Urology
Published in: World Journal of Urology 2/2020

Open Access 01-02-2020 | Cystectomy | Original Article

No increased risk of short-term complications after radical cystectomy for muscle-invasive bladder cancer among patients treated with preoperative chemotherapy: a nation-wide register-based study

Authors: Tomas Jerlström, Ruoqing Chen, Fredrik Liedberg, Ove Andrén, Viveka Ströck, Firas A. S. Aljabery, Abolfazl Hosseini, Amir Sherif, Per-Uno Malmström, Anders Ullén, Truls Gårdmark, Katja Fall

Published in: World Journal of Urology | Issue 2/2020

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Abstract

Purpose

Preoperative chemotherapy is underused in conjunction with radical cystectomy (RC) for muscle-invasive bladder cancer (MIBC) due to concerns for complications and delay of surgery. Prospective data on short-term complications from population-based settings with frequent use of preoperative chemotherapy and standardised reporting of complications is lacking.

Methods

We identified 1,340 patients who underwent RC between 2011 and 2015 in Sweden due to MIBC according to the Swedish Cystectomy Register. These individuals were followed through linkages to several national registers. Propensity score adjusted logistic regression was used to calculate odds ratios (ORs) and 95% confidence intervals (CIs) for complications and death within 90 days of surgery, comparing patients receiving preoperative chemotherapy or not.

Results

Minimum two cycles of preoperative chemotherapy were given to 519 (39%) of the patients, who on average tended to be younger, have higher education, better physical status, and more advanced bladder cancer than patients not receiving chemotherapy. After adjusting for these and other parameters, there was no association between treatment with preoperative chemotherapy and short-term complications (OR 1.06 95% CI 0.82–1.39) or mortality (OR 0.75 95% CI 0.36–1.55). We observed a risk reduction for gastrointestinal complications among patients who received preoperative chemotherapy compared with those who did not (OR 0.49 95% CI 0.30–0.81).

Conclusion

This nation-wide population-based observational study does not suggest that preoperative chemotherapy, in a setting with high utilisation of such treatment, is associated with an increased risk of short-term complications in MIBC patients treated with radical cystectomy.
Appendix
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Metadata
Title
No increased risk of short-term complications after radical cystectomy for muscle-invasive bladder cancer among patients treated with preoperative chemotherapy: a nation-wide register-based study
Authors
Tomas Jerlström
Ruoqing Chen
Fredrik Liedberg
Ove Andrén
Viveka Ströck
Firas A. S. Aljabery
Abolfazl Hosseini
Amir Sherif
Per-Uno Malmström
Anders Ullén
Truls Gårdmark
Katja Fall
Publication date
01-02-2020
Publisher
Springer Berlin Heidelberg
Published in
World Journal of Urology / Issue 2/2020
Print ISSN: 0724-4983
Electronic ISSN: 1433-8726
DOI
https://doi.org/10.1007/s00345-019-02770-2

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