Preoperative CRP is a predictive factor for prolonged hospital stay after radical cystectomy for bladder cancer.

PURPOSE: Radical cystectomy (RC) is a curative treatment for localized bladder cancer. We retrospectively investigated the predictive factors for prolonged hospital stay after RC, including patient characteristics, preoperative laboratory data, surgery-related factors, and postoperative complications.

METHODS

We retrospectively analyzed data from 1,257 bladder cancer patients who underwent RC between 2010 and 2024: 516 open RC (ORC), 206 laparoscopic RC (LRC), and 535 robot-assisted RC (RARC). The cumulative rate of postoperative discharge (living) was calculated based on postoperative hospital stay using the Kaplan-Meier method. Multivariate analyses of factors associated with postoperative hospital stay were performed using Cox regression analysis.

RESULTS

The median age of the cohort was 72.8 years, with 954 patients (75.9%) being male. The median preoperative C-reactive protein (CRP) level was 0.16 mg/dL (range, 0.0-28.3), and 196 patients (15.6%) had a CRP level ≥ 1.0 mg/dL. Multivariate analysis revealed that surgical procedure (RARC vs. ORC, p < 0.001; RARC vs. LRC, p < 0.001), urinary diversion type (ileal conduit vs. neobladder, p = 0.029), and preoperative CRP level (< 1.0 vs. ≥ 1.0 mg/dL, p < 0.001) were significantly associated with postoperative hospital stay. Notably, a preoperative CRP level ≥ 1.0 mg/dL remained significantly associated with postoperative hospital stay, even after adjusting for the surgical period and postoperative complications.

CONCLUSION

A preoperative CRP level ≥ 1.0 mg/dL was an independent predictive factor for prolonged hospital stay after RC for bladder cancer, irrespective of the surgical period, surgical procedures, and postoperative complications.