Radical cystectomy (RC) is the gold standard treatment for muscle-invasive bladder cancer (BCa). Chronic liver disease (CLD) may predispose to worse in-hospital outcomes after RC and ileal conduit, but this association has not been investigated.
The current study addressed this knowledge gap.
Descriptive analyses, propensity score-matching (PSM), and multivariable logistic and Poisson regression models were used to address BCa patients in the National Inpatient Sample treated with RC and ileal conduit (2006-2019).
Of 15,104 RC and ileal conduit patients, 241 (1.6 %) had CLD at baseline. Compared with their non-CLD counterparts, the CLD patients exhibited significantly higher rates of adverse in-hospital outcomes in 9 of 13 categories, namely, acute kidney injury (AKI, Δ+12.0 %), overall complications (Δ+11.0 %), pulmonary complications (Δ+9.0 %), blood transfusions (Δ+8.0 %), prolonged hospital stay (Δ+7.0 %), infectious complications (Δ+7.0 %), critical care therapies (Δ+4.0 %), in-hospital mortality (Δ+3.6 %), and total hospital charges (THC, Δ+18, 042 US$) (all p < 0.05). After multivariable adjustment, CLD independently predicted higher rates of adverse in-hospital outcomes in the same categories, namely, in-hospital mortality (odds ratio [OR], 2.7; 95 % confidence interval [CI], 1.3-4.9), infectious complications (OR, 2.5; 95 % CI 1.6-3.8), AKI (OR, 2.1; 95 % CI 1.6-2.9), pulmonary complications (OR, 2.0; 95 % CI 1.4-2.8), overall complications (OR, 1.9; 95 % CI 1.7-2.9), critical care therapies (OR, 1.6; 95 % CI 1.2-1.9), blood transfusions (OR, 1.4; 95 % CI 1.1-1.9), prolonged hospital stay (OR, 1.4; 95 % CI 1.1-1.8), and THC (OR, 1.2; 95 % CI 1.1-1.4) (all p < 0.05).
Although CLD appears to predispose to higher rates of adverse in-hospital outcomes after RC and ileal conduit, it does not increase the rates of these outcomes in a prohibitive fashion.
Annals of surgical oncology. 2025 Aug 20 [Epub ahead of print]
Federico Polverino, Andrea Marmiroli, Mattia Longoni, Quynh Chi Le, Fabian Falkenbach, Michele Nicolazzini, Calogero Catanzaro, Fred Saad, Jordan A Goyal, Simone Morra, Gianluigi Califano, Roberto La Rocca, Claudia Collà Ruvolo, Alberto Briganti, Felix K H Chun, Markus Graefen, Carlotta Palumbo, Riccardo Schiavina, Gennaro Musi, Shahrokh F Shariat, Nicola Longo, Pierre I Karakiewicz
Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, QC, Canada. ., Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, QC, Canada., Department of Neurosciences, Science of Reproduction and Odontostomatology, University of Naples Federico II, Naples, Italy., Vita-Salute San Raffaele University, Milan, Italy., Department of Urology, Goethe University Frankfurt, University Hospital, Frankfurt am Main, Germany., Martini-Klinik Prostate Cancer Center, University Hospital Hamburg-Eppendorf, Hamburg, Germany., Division of Urology, Department of Translational Medicine, University of Eastern Piedmont, Maggiore della Carità Hospital, Novara, Italy., Division of Urology, IRCCS Azienda Ospedaliero-universitaria di Bologna, Bologna, Italy., Department of Urology, IEO European Institute of Oncology, IRCCS, Milan, Italy., Department of Urology, Weill Cornell Medical College, New York, NY, USA.
PubMed http://www.ncbi.nlm.nih.gov/pubmed/40836149