TY - JOUR
T1 - Predicting factor analysis of postoperative complications after robot-assisted radical cystectomy
T2 - Multicenter KORARC database study
AU - the Korean Robot Assisted Radical Cystectomy (KORARC) Study Group
AU - Kim, Hwanik
AU - Jeong, Byong Chang
AU - Lee, Sangchul
AU - Ku, Ja Hyeon
AU - Kwon, Tae Gyun
AU - Kim, Tae‑Hwan
AU - Jeon, Seung Hyun
AU - Lee, Sang Hyub
AU - Nam, Jong Kil
AU - Kim, Wansuk
AU - Lee, Ji Youl
AU - Hong, Sung Hoo
AU - Rha, Koon Ho
AU - Han, Woong Kyu
AU - Ham, Won Sik
AU - Lee, Young Goo
AU - Lee, Yong Seong
AU - Park, Sung Yul
AU - Yoon, Young Eun
AU - Kang, Sung Gu
AU - Kang, Seok Ho
AU - Oh, Jong Jin
N1 - Funding Information:
This study was supported by the Korean Society of Endourology and Robotics. This work was also supported by Grant No. 02‐2021‐0031 from the Seoul National University Bundang Hospital (SNUBH) Research Fund and Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Education (2020R1A2C1100011).
Publisher Copyright:
© 2022 The Japanese Urological Association.
PY - 2022/9
Y1 - 2022/9
N2 - Objectives: To evaluate postoperative complications following robot-assisted radical cystectomy in patients diagnosed with bladder cancer and reveal if there are predictors for postoperative complications. Methods: Prospectively collected medical records of 730 robot-assisted radical cystectomy patients between 2007/04 and 2019/05 in 13 tertiary referral centers were reviewed. Perioperative outcomes were compared between two groups by postoperative complications (complication vs non-complication). We assessed recurrence-free survival, cancer-specific survival, and overall survival between groups. Regression analyses were implemented to identify factors associated with postoperative complications. Results: Any total and high-grade complication (Clavien–Dindo grade ≥3) rates were 57.8% and 21.1%, respectively. Patients in complication group had significantly higher proportion of diabetes mellitus (P = 0.048), chronic kidney disease (P = 0.011), dyslipidemia (P < 0.001), longer operation time (P = 0.001), more estimated blood loss (P = 0.001), and larger intraoperative fluid volume (P < 0.001). There was a significant difference in cancer-specific survival (log-rank P = 0.038, median cancer-specific survival: both groups not reached). Dyslipidemia (odds ratio 2.59, P = 0.002) and intraoperative fluid volume (odds ratio 1.0002, P = 0.040) were significantly associated with high-grade postoperative complications. Diabetes mellitus (odds ratio 1.97, P = 0.028), chronic kidney disease (odds ratio 1.89, P = 0.046), dyslipidemia (odds ratio 5.94, P = 0.007), and intraoperative fluid volume (odds ratio 1.0002, P = 0.009) were significantly associated with any postoperative complications. Conclusions: Patients with diabetes mellitus, chronic kidney disease, dyslipidemia, or a relatively large intraoperatively infused fluid volume are more likely to develop postoperative complications. Patients with postoperative complications might have a possibility of lower cancer-specific survival rate.
AB - Objectives: To evaluate postoperative complications following robot-assisted radical cystectomy in patients diagnosed with bladder cancer and reveal if there are predictors for postoperative complications. Methods: Prospectively collected medical records of 730 robot-assisted radical cystectomy patients between 2007/04 and 2019/05 in 13 tertiary referral centers were reviewed. Perioperative outcomes were compared between two groups by postoperative complications (complication vs non-complication). We assessed recurrence-free survival, cancer-specific survival, and overall survival between groups. Regression analyses were implemented to identify factors associated with postoperative complications. Results: Any total and high-grade complication (Clavien–Dindo grade ≥3) rates were 57.8% and 21.1%, respectively. Patients in complication group had significantly higher proportion of diabetes mellitus (P = 0.048), chronic kidney disease (P = 0.011), dyslipidemia (P < 0.001), longer operation time (P = 0.001), more estimated blood loss (P = 0.001), and larger intraoperative fluid volume (P < 0.001). There was a significant difference in cancer-specific survival (log-rank P = 0.038, median cancer-specific survival: both groups not reached). Dyslipidemia (odds ratio 2.59, P = 0.002) and intraoperative fluid volume (odds ratio 1.0002, P = 0.040) were significantly associated with high-grade postoperative complications. Diabetes mellitus (odds ratio 1.97, P = 0.028), chronic kidney disease (odds ratio 1.89, P = 0.046), dyslipidemia (odds ratio 5.94, P = 0.007), and intraoperative fluid volume (odds ratio 1.0002, P = 0.009) were significantly associated with any postoperative complications. Conclusions: Patients with diabetes mellitus, chronic kidney disease, dyslipidemia, or a relatively large intraoperatively infused fluid volume are more likely to develop postoperative complications. Patients with postoperative complications might have a possibility of lower cancer-specific survival rate.
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U2 - 10.1111/iju.14815
DO - 10.1111/iju.14815
M3 - Article
C2 - 35137466
AN - SCOPUS:85124820995
SN - 0919-8172
VL - 29
SP - 939
EP - 946
JO - International Journal of Urology
JF - International Journal of Urology
IS - 9
ER -
