Single-surgeon outcomes of open radical cystectomy for muscle-invasive bladder cancer: Experience from a tertiary center in Azerbaijan.

OBJECTIVE

Radical cystectomy is the standard treatment for muscle-invasive bladder cancer (MIBC). This study presents the first analysis of open radical cystectomy (ORC) outcomes in Azerbaijan, where robotic surgery is unavailable.

METHODS

We retrospectively analyzed 106 patients with non-metastatic MIBC who underwent ORC with bilateral pelvic lymph node dissection and Bricker ileal conduit reconstruction, performed by a single surgeon between 2014 and 2024. Demographic data, comorbidities, operative metrics (duration, blood loss), complications, length of stay, and follow-up data were analyzed.

RESULTS

The cohort's mean age was 64.2 years (72.6 % male), with common comorbidities including hypertension (33 %), diabetes (33 %), and coronary artery disease (24.5 %). The median operative time was 300 min and blood loss was 450 mL. Postoperative complications occurred in 9.4 %, primarily urinary tract infections. No intraoperative complications or in-hospital mortalities occurred. Longer hospital stays were associated with advanced age (p < 0.001), higher body mass index (p = 0.042), longer operative time (p < 0.001), and increased blood loss (p = 0.008). Of all patients, 58.5 % were followed for a median of 71.3 months with no observed recurrences. There were three non-cancer related deaths.

CONCLUSION

This initial report from Azerbaijan demonstrates acceptable perioperative outcomes for ORC in MIBC, despite the absence of robotic surgery. Our findings emphasize optimizing surgical efficiency, comorbidity management, and strengthening follow-up to enhance patient outcomes in resource-limited settings.