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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 3/2015

01-03-2015 | Urologic Oncology

Evidence from the ‘PROspective MulticEnTer RadIcal Cystectomy Series 2011 (PROMETRICS 2011)’ Study: How are Preoperative Patient Characteristics Associated with Urinary Diversion Type After Radical Cystectomy for Bladder Cancer?

Authors: Marianne Schmid, MD, Michael Rink, MD, Miriam Traumann, MD, Patrick J. Bastian, MD, Georg Bartsch, MD, Jörg Ellinger, MD, Marc-Oliver Grimm, MD, Boris Hadaschik, MD, Axel Haferkamp, MD, Oliver W. Hakenberg, MD, Atiqullah Aziz, MD, Florian Hartmann, MD, Edwin Herrmann, MD, Markus Hohenfellner, MD, Günter Janetschek, MD, Michael Gierth, MD, Sasc ha Pahernik, MD, Chris Protzel, MD, Jan Roigas, MD, Murat Gördük, MD, Lukas Lusuardi, MD, Matthias May, MD, Quoc-Dien Trinh, MD, Margit Fisch, MD, Felix K.H. Chun, MD, PROMETRICS 2011 Research Group

Published in: Annals of Surgical Oncology | Issue 3/2015

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Abstract

Purpose

The aim of this study was to examine preoperative patients’ characteristics associated with the urinary diversion (UD) type (continent vs. incontinent) after radical cystectomy (RC) and UD-associated postoperative complications.

Materials

In 2011, 679 bladder cancer patients underwent RC at 18 European tertiary care centers. Data were prospectively collected within the ‘PROspective MulticEnTer RadIcal Cystectomy Series 2011’ (PROMETRICS 2011). Logistic regression models assessed the impact of preoperative characteristics on UD type and evaluated diversion-related complication rates.

Results

Of 570 eligible patients, 28.8, 2.6, 59.3, and 9.3 % received orthotopic neobladders, continent cutaneous pouches, ileal conduits, and ureterocutaneostomies, respectively. In multivariable analyses, female sex (odds ratio [OR] 3.9; p = 0.002), American Society of Anesthesiologists score ≥3 (OR 2.3; p = 0.02), an age-adjusted Charlson Comorbidity Index ≥3 (OR 4.1; p < 0.001), and a positive biopsy of the prostatic urethra in the last transurethral resection of the bladder prior to RC (OR 4.9; p = 0.03) were independently associated with incontinent UD. There were no significant differences in 30- and/or 90-day complication rates between the UD types. Perioperative transfusion rates and 90-day mortality were significantly associated with incontinent UD (p < 0.001, respectively). Limitations included the small sample size and a certain level of heterogeneity in the application of clinical pathways between the different participating centers.

Conclusions

Within this prospective contemporary cohort of European RC patients treated at tertiary care centers, the majority of patients received an incontinent UD. Female sex and pre-existing comorbidities were associated with receiving an incontinent UD. The risk of overall complications did not vary according to UD type.
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Metadata
Title
Evidence from the ‘PROspective MulticEnTer RadIcal Cystectomy Series 2011 (PROMETRICS 2011)’ Study: How are Preoperative Patient Characteristics Associated with Urinary Diversion Type After Radical Cystectomy for Bladder Cancer?
Authors
Marianne Schmid, MD
Michael Rink, MD
Miriam Traumann, MD
Patrick J. Bastian, MD
Georg Bartsch, MD
Jörg Ellinger, MD
Marc-Oliver Grimm, MD
Boris Hadaschik, MD
Axel Haferkamp, MD
Oliver W. Hakenberg, MD
Atiqullah Aziz, MD
Florian Hartmann, MD
Edwin Herrmann, MD
Markus Hohenfellner, MD
Günter Janetschek, MD
Michael Gierth, MD
Sasc ha Pahernik, MD
Chris Protzel, MD
Jan Roigas, MD
Murat Gördük, MD
Lukas Lusuardi, MD
Matthias May, MD
Quoc-Dien Trinh, MD
Margit Fisch, MD
Felix K.H. Chun, MD
PROMETRICS 2011 Research Group
Publication date
01-03-2015
Publisher
Springer US
Published in
Annals of Surgical Oncology / Issue 3/2015
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-014-4029-3

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