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Complication rate after cystectomy following pelvic radiotherapy: an international, multicenter, retrospective series of 682 cases
P. Gontero, F. Pisano, J. Palou, S. Joniau, M. Albersen, R. Colombo, A. Briganti, F. Pellucchi, OR. Faba, BW. van Rhijn, EF. van de Putte, M. Babjuk, HM. Fritsche, R. Mayr, P. Albers, G. Niegisch, J. Anract, A. Masson-Lecomte, A. De la Taille, M....
Jazyk angličtina Země Německo
Typ dokumentu časopisecké články, multicentrická studie
- MeSH
- cystektomie * MeSH
- hodnocení rizik MeSH
- internacionalita MeSH
- lidé středního věku MeSH
- lidé MeSH
- močový měchýř účinky záření MeSH
- nádory břicha radioterapie MeSH
- nádory močového měchýře chirurgie MeSH
- pooperační komplikace epidemiologie MeSH
- retrospektivní studie MeSH
- senioři MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- multicentrická studie MeSH
PURPOSE: Conflicting evidence exists on the complication rates after cystectomy following previous radiation (pRTC) with only a few available series. We aim to assess the complication rate of pRTC for abdominal-pelvic malignancies. 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.
Academic Urology Unit University of Sheffield Sheffield UK
Department of Uro oncolgy Fundacio Puigvert University of Barcelona Barcelona Spain
Department of Urologic Sciences University of British Columbia Vancouver BC Canada
Department of Urology CHU Bichat Paris France
Department of Urology Heinrich Heine University Medical Faculty Düsseldorf Germany
Department of Urology Henri Mondor Academic Hospital Creteil France
Department of Urology Hôpital La Pitié Salpétrière Paris 6 University Paris France
Department of Urology Hôpital Saint Louis Université Paris Diderot Paris France
Department of Urology Kremlin Bicetre Hospital Assistance Publique Hôpitaux de Paris Paris France
Department of Urology Mayo Clinic Rochester USA
Department of Urology Medical University of Vienna Vienna Austria
Department of Urology Molinette Hospital University of Torino School of Medicine Turin Italy
Department of Urology Motol Hospital University of Praha Prague Czech Republic
Department of Urology N N Blokhin Russian Cancer Research Center Moscow Russia
Department of Urology Ospedale di Carpi Modena Modena Italy
Department of Urology Ospedale S Chiara Trento Italy
Department of Urology Rabin Medical Centre Tel Aviv Israel
Department of Urology Radboud University Nijmegen Medical Centre Nijmegen The Netherlands
Department of Urology Regensburg University Regensburg Germany
Department of Urology University Hospital Tübingen Tübingen Germany
Department of Urology University Medical Center Hamburg Eppendorf Hamburg Germany
Department of Urology University Medical Center Rostock Rostock Germany
Department of Urology University of Florence University Hospital of Florence Florence Italy
Department of Urology University of Miami Miller School of Medicine Miami FL USA
Department of Urology Weill Cornell Medical College New York USA
Netherland Cancer Institute Amsterdam The Netherlands
Unit of Urology Division of Oncology URI IRCCS Ospedale San Raffaele Milan Italy
Citace poskytuje Crossref.org
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- $a Gontero, Paolo $u Department of Urology, Molinette Hospital, University of Torino School of Medicine, Turin, Italy
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- $a Complication rate after cystectomy following pelvic radiotherapy: an international, multicenter, retrospective series of 682 cases / $c P. Gontero, F. Pisano, J. Palou, S. Joniau, M. Albersen, R. Colombo, A. Briganti, F. Pellucchi, OR. Faba, BW. van Rhijn, EF. van de Putte, M. Babjuk, HM. Fritsche, R. Mayr, P. Albers, G. Niegisch, J. Anract, A. Masson-Lecomte, A. De la Taille, M. Roupret, B. Peyronnet, T. Cai, AJ. Witjes, M. Bruins, J. Baniel, R. Mano, A. Lapini, F. Sessa, J. Irani, M. Brausi, A. Stenzl, JR. Karnes, D. Scherr, P. O'Malley, B. Taylor, SF. Shariat, P. Black, H. Abdi, VB. Matveev, O. Samuseva, D. Parekh, M. Gonzalgo, MW. Vetterlein, A. Aziz, M. Fisch, J. Catto, KH. Pang, E. Xylinas, M. Rink, Young Academic Urologists Urothelial Carcinoma Group of the European Association of Urology
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- $a PURPOSE: Conflicting evidence exists on the complication rates after cystectomy following previous radiation (pRTC) with only a few available series. We aim to assess the complication rate of pRTC for abdominal-pelvic malignancies. 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.
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