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Tytuł:
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Complication rate after cystectomy following pelvic radiotherapy: an international, multicenter, retrospective series of 682 cases.
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Autorzy:
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Gontero P; Department of Urology, Molinette Hospital, University of Torino School of Medicine, Turin, Italy.
Pisano F; Department of Urology, Molinette Hospital, University of Torino School of Medicine, Turin, Italy. .; Department of Uro-oncolgy, Fundacio Puigvert, University of Barcelona, Barcelona, Spain. .
Palou J; Department of Uro-oncolgy, Fundacio Puigvert, University of Barcelona, Barcelona, Spain.
Joniau S; Oncologic and Reconstructive Urology, Department of Urology, University Hospitals Leuven, Louvain, Belgium.
Albersen M; Oncologic and Reconstructive Urology, Department of Urology, University Hospitals Leuven, Louvain, Belgium.
Colombo R; Unit of Urology/Division of Oncology, URI, IRCCS Ospedale San Raffaele, Milan, Italy.
Briganti A; Unit of Urology/Division of Oncology, URI, IRCCS Ospedale San Raffaele, Milan, Italy.
Pellucchi F; Unit of Urology/Division of Oncology, URI, IRCCS Ospedale San Raffaele, Milan, Italy.
Faba OR; Department of Uro-oncolgy, Fundacio Puigvert, University of Barcelona, Barcelona, Spain.
van Rhijn BW; Netherland Cancer Institute, Amsterdam, The Netherlands.
van de Putte EF; Netherland Cancer Institute, Amsterdam, The Netherlands.
Babjuk M; Department of Urology, Motol Hospital, University of Praha, Prague, Czech Republic.
Fritsche HM; Department of Urology, Regensburg University, Regensburg, Germany.
Mayr R; Department of Urology, Regensburg University, Regensburg, Germany.
Albers P; Department of Urology, Heinrich-Heine-University, Medical Faculty, Düsseldorf, Germany.
Niegisch G; Department of Urology, Heinrich-Heine-University, Medical Faculty, Düsseldorf, Germany.
Anract J; Department of Urology, CHU Bichat, Paris, France.
Masson-Lecomte A; Department of Urology, Hôpital Saint-Louis, Université Paris-Diderot, Paris, France.
De la Taille A; Department of Urology, Henri Mondor Academic Hospital, Creteil, France.
Roupret M; Department of Urology, Hôpital La Pitié-Salpétrière, Paris 6 University, Paris, France.
Peyronnet B; Department of Urology, Hôpital La Pitié-Salpétrière, Paris 6 University, Paris, France.
Cai T; Department of Urology, Ospedale S. Chiara, Trento, Italy.
Witjes AJ; Department of Urology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands.
Bruins M; Department of Urology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands.
Baniel J; Department of Urology, Rabin Medical Centre, Tel Aviv, Israel.
Mano R; Department of Urology, Rabin Medical Centre, Tel Aviv, Israel.
Lapini A; Department of Urology, University of Florence, University Hospital of Florence, Florence, Italy.
Sessa F; Department of Urology, University of Florence, University Hospital of Florence, Florence, Italy.
Irani J; Department of Urology, Kremlin-Bicetre Hospital, Assistance Publique Hôpitaux de Paris, Paris, France.
Brausi M; Department of Urology, Ospedale di Carpi-Modena, Modena, Italy.
Stenzl A; Department of Urology, University Hospital Tübingen, Tübingen, Germany.
Karnes JR; Department of Urology, Mayo Clinic, Rochester, USA.
Scherr D; Department of Urology, Weill Cornell Medical College, New York, USA.
O'Malley P; Department of Urology, Weill Cornell Medical College, New York, USA.
Taylor B; Department of Urology, Weill Cornell Medical College, New York, USA.
Shariat SF; Department of Urology, Medical University of Vienna, Vienna, Austria.
Black P; Department of Urologic Sciences, University of British Columbia, Vancouver, BC, Canada.
Abdi H; Department of Urologic Sciences, University of British Columbia, Vancouver, BC, Canada.
Matveev VB; Department of Urology, N.N. Blokhin Russian Cancer Research Center, Moscow, Russia.
Samuseva O; Department of Urology, N.N. Blokhin Russian Cancer Research Center, Moscow, Russia.
Parekh D; Department of Urology, University of Miami Miller School of Medicine, Miami, FL, USA.
Gonzalgo M; Department of Urology, University of Miami Miller School of Medicine, Miami, FL, USA.
Vetterlein MW; Department of Urology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Aziz A; Department of Urology, University Medical Center Rostock, Rostock, Germany.
Fisch M; Department of Urology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Catto J; Academic Urology Unit, University of Sheffield, Sheffield, UK.
Pang KH; Academic Urology Unit, University of Sheffield, Sheffield, UK.
Xylinas E; Department of Urology, CHU Bichat, Paris, France.
Rink M; Department of Urology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
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Corporate Authors:
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Young Academic Urologists Urothelial Carcinoma Group of the European Association of Urology
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Źródło:
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World journal of urology [World J Urol] 2020 Aug; Vol. 38 (8), pp. 1959-1968. Date of Electronic Publication: 2019 Nov 06.
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Typ publikacji:
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Journal Article; Multicenter Study
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Język:
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English
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Imprint Name(s):
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Original Publication: [Berlin ; New York] : Springer International, 1983-
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MeSH Terms:
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Cystectomy*
Abdominal Neoplasms/*radiotherapy
Postoperative Complications/*epidemiology
Urinary Bladder/*radiation effects
Urinary Bladder Neoplasms/*surgery
Aged ; Female ; Humans ; Internationality ; Male ; Middle Aged ; Retrospective Studies ; Risk Assessment
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References:
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Stein JP, Lieskovsky G, Cote R et al (2001) Radical cystectomy in the treatment of invasive bladder cancer: long-term results in 1,054 patients. J Clin Oncol 19(3):666–675. https://doi.org/10.1200/jco.2001.19.3.666. (PMID: 10.1200/jco.2001.19.3.66611157016)
Novara G, De Marco V, Aragona M et al (2009) Complications and mortality after radical cystectomy for bladder transitional cell cancer. J Urol 182:914–921. https://doi.org/10.1016/j.juro.2009.05.032. (PMID: 10.1016/j.juro.2009.05.03219616246)
Shabsigh A, Korets R, Vora KC et al (2009) Defining early morbidity of radical cystectomy for patients with bladder cancer using a standardized reporting methodology. Eur Urol 55(1):164–176. https://doi.org/10.1016/j.eururo.2008.07.031. (PMID: 10.1016/j.eururo.2008.07.03118675501)
Chang SS, Alberts GL, Smith JA, Cookson MS (2004) Ileal conduit urinary diversion in patients with previous history of abdominal/pelvic irradiation. World J Urol 22(4):272–276. https://doi.org/10.1007/s00345-004-0446-4. (PMID: 10.1007/s00345-004-0446-415448995)
Eisenberg MS, Dorin RP, Bartsch G, Cai J, Miranda G, Skinner EC (2010) Early complications of cystectomy after high dose pelvic radiation. J Urol 184(6):2264–2269. https://doi.org/10.1016/j.juro.2010.08.007. (PMID: 10.1016/j.juro.2010.08.00720952024)
Eswara JR, Efstathiou JA, Heney NM et al (2012) Complications and long-term results of salvage cystectomy after failed bladder sparing therapy for muscle invasive bladder cancer. J Urol 187(2):463–468. https://doi.org/10.1016/j.juro.2011.09.159. (PMID: 10.1016/j.juro.2011.09.15922177159)
Nguyen DP, Awamlh Al Hussein Al, Faltas BM et al (2015) Radical cystectomy for bladder cancer in patients with and without a history of pelvic irradiation: survival outcomes and diversion-related complications. Urology 86(1):99–107. https://doi.org/10.1016/j.urology.2015.02.061. (PMID: 10.1016/j.urology.2015.02.06126142590)
Ramani VAC, Maddineni SB, Grey BR, Clarke NW (2010) Differential complication rates following radical cystectomy in the irradiated and nonirradiated pelvis. Eur Urol 57(6):1058–1063. https://doi.org/10.1016/j.eururo.2009.12.002. (PMID: 10.1016/j.eururo.2009.12.00220022162)
Yee DS, Shariat SF, Lowrance WT et al (2010) Impact of previous radiotherapy for prostate cancer on clinical outcomes of patients with bladder cancer. J Urol 183(5):1751–1756. https://doi.org/10.1016/j.juro.2010.01.014. (PMID: 10.1016/j.juro.2010.01.014202990354295901)
Nieuwenhuijzen JA, Horenblas S, Meinhardt W, van Tinteren H, Moonen LMF (2004) Salvage cystectomy after failure of interstitial radiotherapy and external beam radiotherapy for bladder cancer. BJU Int 94(6):793–797. https://doi.org/10.1111/j.1464-410X.2004.05034.x. (PMID: 10.1111/j.1464-410X.2004.05034.x15476510)
Edsmyr F, Moberger G, Wadström L (1971) Carcinoma of the bladder. Cystectomy after supervoltage therapy. Scand J Urol Nephrol 5(3):215–221. http://www.ncbi.nlm.nih.gov/pubmed/4998747 . Accessed 12 Jan 2018.
Lund F (1980) Cystectomy following full course irradiation. Bladder tumors and other topics in urological oncology. Springer, Boston, pp 287–289. https://doi.org/10.1007/978-1-4613-3030-1_56. (PMID: 10.1007/978-1-4613-3030-1_56)
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Jayram G, Katz MH, Steinberg GD (2010) Radical cystectomy in patients previously treated for localized prostate cancer. Urology 76(6):1430–1433. https://doi.org/10.1016/j.urology.2010.01.048. (PMID: 10.1016/j.urology.2010.01.04820381130)
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Contributed Indexing:
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Investigator: E Xylinas; M Rink
Keywords: Bladder cancer; Complications; Radiation therapy; Radical cystectomy; Urinary diversion
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Entry Date(s):
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Date Created: 20191107 Date Completed: 20210408 Latest Revision: 20230426
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Update Code:
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20240104
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DOI:
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10.1007/s00345-019-02982-6
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PMID:
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31691084
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Purpose: Conflicting evidence exists on the complication rates after cystectomy following previous radiation (pRTC) with only a few available series. We aim to assess the complication rate of pRTC for abdominal-pelvic malignancies.
Methods: Patients treated with radical cystectomy following any previous history of RT and with available information on complications for a minimum of 1 year were included. Univariable and multivariable logistic regression models were used to assess the relationship between the variable parameters and the risk of any complication.
Results: 682 patients underwent pRTC after a previous RT (80.5% EBRT) for prostate, bladder (BC), gynecological or other cancers in 49.1%, 27.4%, 9.8% and 12.9%, respectively. Overall, 512 (75.1%) had at least one post-surgical complication, classified as Clavien ≥ 3 in 29.6% and Clavien V in 2.9%. At least one surgical complication occurred in 350 (51.3%), including bowel leakage in 6.2% and ureteric stricture in 9.4%. A medical complication was observed in 359 (52.6%) patients, with UTI/pyelonephritis being the most common (19%), followed by renal failure (12%). The majority of patients (86%) received an incontinent urinary diversion. In multivariable analysis adjusted for age, gender and type of RT, patients treated with RT for bladder cancer had a 1.7 times increased relative risk of experiencing any complication after RC compared to those with RT for prostate cancer (p = 0.023). The type of diversion (continent vs non-continent) did not influence the risk of complications.
Conclusion: pRTC carries a high rate of major complications that dramatically exceeds the rates reported in RT-naïve RCs.
