Complication rate after cystectomy following pelvic radiotherapy: an international, multicenter, retrospective series of 682 cases.
Обработка статьи · этапы, ошибки и управление
Ошибки и ограничения
История · было → стало
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Gontero Paolo, Pisano Francesca, Palou Joan, Joniau Steven, Albersen Maarten, Colombo Renzo, Briganti Alberto, Pellucchi Federico, Faba Oscar Rodriguez, van Rhijn Bas W, van de Putte Elies Fransen, Babjuk Marko, Fritsche Hanz Martin, Mayr Roman, Albers Peter, Niegisch Gunter, Anract Julien, Masson-Lecomte Alexandra, De la Taille Alexandre, Roupret Morgan, Peyronnet Benoit, Cai Tomaso, Witjes Alfred J, Bruins Max, Baniel Jack, Mano Roy, Lapini Alberto, Sessa Francesco, Irani Jaques, Brausi Maurizio, Stenzl Arnulf, Karnes Jeffrey R, Scherr Douglas, O'Malley Padraic, Taylor Benjamin, Shariat Shahrokh F, Black Peter, Abdi Hamidreza, Matveev Vsevolod B, Samuseva Olga, Parekh Dipen, Gonzalgo Mark, Vetterlein Malte W, Aziz Atiqullah, Fisch Margit, Catto James, Pang Karl H, Xylinas Evanguelos, Rink Michael, Young Academic Urologists Urothelial Carcinoma Group of the European Association of Urology
Аннотация
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.