SUO 2017: Complications Following Radical Cystectomy And Urinary Diversion Surgery

Washington, DC ( The authors state that most research on radical cystectomy (RC) and urinary diversion (UD) surgeries has focused on short-term complications (30-90 days post-surgery), with limited data on longer-term complications. Moreover, studies generally have been conducted in academic or high-volume tertiary care settings, although a high percentage of about 40% of surgeries are performed in community-based settings. The authors therefore conducted a study within 3 community-based integrated healthcare systems to describe complications in the 2 years post-RC/UD surgery.

A retrospective cohort was created of all patients age >=21 years who had RC/UD surgery for bladder cancer between 1/2010 and 6/2015. Complications were identified via diagnosis and procedure codes extracted from the electronic health record and grouped into categories.
A subset of patients were prospectively recruited and surveyed (n=269) at approximately 6 months post-surgery.

Most of the 1,063 patients were white (83%) and male (78%) with a mean age at surgery of 70 years. Ileal conduit (80%) was more common than neobladder or pouch diversions. Almost 70% of patients had a comorbidity pre-surgery. Complications during the 2 years post-RC/UD surgery were common; 76% had >=1. Complication rates were similar by sex, but slightly higher among Asians and continent UD patients. In open-ended survey responses, patients noted the substantial impact of complications, particularly infections, on recovery; they commented on frequent UTIs, severe infections, and sequelae that kept them from working months after surgery.

Complications in the two years post-RC/UD were common among a large, community-based cohort of patients undergoing RC. While attention has focused on the immediate post-surgical time period, these data suggest that new or ongoing complications from RC necessitate continued monitoring and support for a long period of time for bladder cancer survivors.

Presented by: Kim Danforth, Southern California Permanente Medical Group, San Diego, CA, USA

Written by: Hanan Goldberg, MD, Urologic Oncology Fellow (SUO), University of Toronto, Princess Margaret Cancer Centre, @GoldbergHanan, at the 18th Annual Meeting of the Society of Urologic Oncology, November 29-December 1, 2017 – Washington, DC