World Journal of Nephrology and Urology, ISSN 1927-1239 print, 1927-1247 online, Open Access
Article copyright, the authors; Journal compilation copyright, World J Nephrol Urol and Elmer Press Inc
Journal website http://www.wjnu.org

Original Article

Volume 2, Number 1, June 2013, pages 1-9


Have Progression-Free Survival and Cancer-Specific Survival in Bladder Tumors Changed in Recent Decades?

Figures

Figure 1.
Figure 1. PFS in n = 563.
Figure 2.
Figure 2. FPS in the four decades studied.
Figure 3.
Figure 3. CSS in the tour decades studied.

Tables

Table 1. Variables Studied
 
Pre-Cystectomy VariablesPeri-Cystectomy VariablesPost-Cystectomy Variables
TURBT: Transurethral resection of bladder tumour; SBC: Superficial bladder cancer; UC: Urothelial carcinoma; UUT: Upper urinary tract; CT: Chemotherapy; BC: Bladder cancer.
GenderTransfusionHospital stay
AgeType of catheterisationFollow-up
SmokerUreteral reimplantationAdjuvant CT
AlcoholPathological stage (pT)Major perioperative complications
Risk occupationTumor gradeMinor perioperative complications
Living environmentLymph node involvement (pN)Late-onset complications
ComorbidityPresence of CISTumor recurrence in UUT
Clinical presentationP53
Clinical stage of TURBTAnatomical pathology Terminal ureter
History of SBCUreterectomy
History of UC in UUTAnatomical pathology type
Neoadjuvant CTOrgan confinement
Tumour in UUT concomitantly with BC

 

Table 2. Major Perioperative Complications, N = 563
 
TypeN° pacientes(% respecto a N = 563)
Major perioperative complications (< 30 days).
Early reoperation (bleeding, peritonitis, occlusion)12(2.1%)
SurgicalRectal injury5(2.3%)
Evisceration8
Fistulas (with action)Intestinal leakage11(2.1%)
Enteroneovesical fistula1
Multi-organ failure2(0.3%)
InfectiousSepsis9(1.7%)
Pseudomembranous colitis1
PT20(3%)
CardiologicalAcute MI2(1.2%)
Acute pulmonary edema5
NeurologicalCVA1(0.1%)
RespiratoryRespiratory failure2(0.5%)
Bronchoaspiration1
DigestiveLiver failure3(0.5%)
Perioperative mortality36(6.4%)

 

Table 3. Minor Perioperative Complications (< 30 Days)
 
TypeN° patients (% of N = 563)
Prolonged ileus47 (8.3%)
Abscess (with action)11 (1.9%)
Infected wound26 (4.6%)
Urinary leak (with action)15 (2.6%)
UTI with repercussion, pyelonephritis10 (1.7%)
DVT5 (0.8%)
Cardiac arrhythmia1 (0.1%)
Pneumonia26 (4,.6%)
Metabolic acidosis9 (1.5%)
Upper GI bleeding14 (2.4%)
Cholecystitis1 (0.1%)

 

Table 4. Late-Onset Complications, N = 563
 
TypeN° pacientes (% de N = 563)
Repair of the derivationIn Mainz I19 (1.5%)
Hautmann neobladder repair1
Reparacion estoma Bricker7
Reconversion of the derivationTo the colonic conduit17 (1.2%)
Reconversion to Bricker6
Lts reservoir (with action)23 (4%)
Ureteral anastomosis stricture (with action)46 (8%)
Ureteral anastomosis stricture (with action)18 (3.1%)
Retentionist neobladder (self-catheterism)12 (2.1%)
Reintervention due to occlusion7(1.2%)
Eventration: mesh4 (0.7%)
Parastomal hernia repair1 (0.1%)

 

Table 5. PFS Predictive Model
 
VariableBSEWaldGlPO.R95% IC para Exp (B)
InferiorSuperior
Pathological organ confinement1.0770.28314.44510.0002.9361.6855.117
Nodal involvement0.8610.21416.21910.0002.3651.5563.595

 

Table 6. CSS Predictive Model
 
VariableBSEWaldglPO.R95% CI for Exp(B)
InferiorSuperior
Pathological organ confinement0.9060.23315.09710.0002.4751.5673.909
Nodal involvement0.8490.19219.46610.0002.3361.6033.406

 

Table 7. Mortality and Morbidity in Different Series
 
Perioperative mortality and % of complications in radical cystectomy
ReferentesMortalityMorbidity
Lowrance et al [7]1.7%41%
Skinner et al [10]2.4%28%
Lee et al [11]1.6%45%
Stimson [13]2.1%(days) y 6.9%(90 d)26%
Chahal [14]8.6%25.6%
Frazier et al [21]2.5%31.9%
Freiha [22]3.3%41%
Stein et al [23]2.5%28%
Hautmann et al [24]3.0%39%