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Cystectomy for blad...
Cystectomy for bladder cancer in Sweden : short-term outcomes after centralization
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- Liedberg, Fredrik (author)
- Lund University,Lunds universitet,Urologi - blåscancer, Malmö,Forskargrupper vid Lunds universitet,LUCC: Lunds universitets cancercentrum,Övriga starka forskningsmiljöer,Urinblåsecancer,Sektion I,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Urology - urothelial cancer, Malmö,Lund University Research Groups,LUCC: Lund University Cancer Centre,Other Strong Research Environments,Urothelial cancer,Section I,Department of Clinical Sciences, Lund,Faculty of Medicine,Skåne University Hospital,Skane Univ Hosp, Sweden; Lund Univ, Sweden
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- Hagberg, Oskar (author)
- Lund University,Lunds universitet,Matematisk statistik,Matematikcentrum,Institutioner vid LTH,Lunds Tekniska Högskola,Urologi - blåscancer, Malmö,Forskargrupper vid Lunds universitet,Mathematical Statistics,Centre for Mathematical Sciences,Departments at LTH,Faculty of Engineering, LTH,Urology - urothelial cancer, Malmö,Lund University Research Groups,Lund Univ, Sweden
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- Aljabery, Firas (author)
- Linköpings universitet,Linköping University,Avdelningen för kirurgi, ortopedi och onkologi,Medicinska fakulteten,Region Östergötland, Urologiska kliniken i Östergötland
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- Andrén, Ove (author)
- Section of Urology, Department of Surgery, Skellefteå Hospital, Sweden,Skelleftea Hosp, Sweden
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- Falini, Victor (author)
- Regional Cancercenter South, Lund, Sweden,Federation of Regional Cancer Centers (RCC),Reg Canc Ctr South, Sweden
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- Gårdmark, Truls (author)
- Department of Clinical Sciences, Danderyd Hospital, Karolinska Institute, Stockholm, Sweden,Karolinska Inst, Sweden
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- Ströck, Viveka (author)
- Department of Urology, Sahlgrenska University Hospital and Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Sweden,Univ Gothenburg, Sweden
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- Jerlström, Tomas, 1969- (author)
- Örebro University,Örebro universitet,Institutionen för medicinska vetenskaper,Region Örebro län,Department of Urology, School of Medical Sciences,Univ Gothenburg, Sweden
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(creator_code:org_t)
- Taylor & Francis, 2024
- 2024
- English.
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In: Scandinavian journal of urology. - : Taylor & Francis. - 2168-1805 .- 2168-1813. ; 59, s. 84-89
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Abstract
Subject headings
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- OBJECTIVE: Radical cystectomy (RC) for bladder cancer is associated with an inherent risk of complications and even postoperative mortality. The number of hospitals performing RC has decreased in Sweden over time, and since a formal regional centralization in 2017 cystectomy care is currently provided by nine hospitals.MATERIAL AND METHODS: In the Swedish National Urinary Bladder Cancer Register (SNRUBC) 90-day complications after RC have been registered with high coverage since 2012. Descriptive data and short-term outcomes were compared in relation to centralization of the cystectomy care by stratifying data before (2012-2016) and after (2017-2023).RESULTS: Out of all 4,638 cystectomies, 2,738 (59%) were performed after the centralization in 2017 and onwards. The median age at RC increased from 71 (Inter Quartile Range [IQR] 65-76) to 73 (IQR 67-77) years, and the proportion of patients with comorbidity (American Society of Anesthesiologists [ASA] 3 or 4) increased from 32% to 37% after the centralization (p < 0.001). The number of patients suffering from high-grade complications within 90 days of surgery corresponding to Clavien grade three were 345 (18%) and 407 (15%), and corresponding to Clavien grade four 61 (3%) and 64 (2%) before and after centralization, respectively. Reoperations within 90 days of RC decreased from 234/1,900 (12%) to 208/2,738 (8%) (p < 0.001), and 90-day mortality decreased from 84/1,900 (4%) to 85/2,738 (3%) (p = 0.023) before and after centralization, respectively.CONCLUSION: After the centralization of the cystectomy-care in Sweden, older patients and individuals with more extensive comorbidity were offered RC whereas 90-day mortality and the proportion of patients subjected to reoperations within 90 days of surgery decreased without increasing waiting times.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Urologi och njurmedicin (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Urology and Nephrology (hsv//eng)
Keyword
- bladder cancer
- radical cystectomy
- centralization
- hospital volume
Publication and Content Type
- ref (subject category)
- art (subject category)
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