World J Nephrol Urol

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?

**Table 1.** Variables Studied
Pre-Cystectomy Variables	Peri-Cystectomy Variables	Post-Cystectomy Variables
TURBT: Transurethral resection of bladder tumour; SBC: Superficial bladder cancer; UC: Urothelial carcinoma; UUT: Upper urinary tract; CT: Chemotherapy; BC: Bladder cancer.
Gender	Transfusion	Hospital stay
Age	Type of catheterisation	Follow-up
Smoker	Ureteral reimplantation	Adjuvant CT
Alcohol	Pathological stage (pT)	Major perioperative complications
Risk occupation	Tumor grade	Minor perioperative complications
Living environment	Lymph node involvement (pN)	Late-onset complications
Comorbidity	Presence of CIS	Tumor recurrence in UUT
Clinical presentation	P53
Clinical stage of TURBT	Anatomical pathology Terminal ureter
History of SBC	Ureterectomy
History of UC in UUT	Anatomical pathology type
Neoadjuvant CT	Organ confinement
	Tumour in UUT concomitantly with BC

Table 1. Variables Studied

Pre-Cystectomy Variables

Peri-Cystectomy Variables

Post-Cystectomy Variables

TURBT: Transurethral resection of bladder tumour; SBC: Superficial bladder cancer; UC: Urothelial carcinoma; UUT: Upper urinary tract; CT: Chemotherapy; BC: Bladder cancer.

Gender

Transfusion

Hospital stay

Age

Type of catheterisation

Follow-up

Smoker

Ureteral reimplantation

Adjuvant CT

Alcohol

Pathological stage (pT)

Major perioperative complications

Risk occupation

Tumor grade

Minor perioperative complications

Living environment

Lymph node involvement (pN)

Late-onset complications

Comorbidity

Presence of CIS

Tumor recurrence in UUT

Clinical presentation

P53

Clinical stage of TURBT

Anatomical pathology Terminal ureter

History of SBC

Ureterectomy

History of UC in UUT

Anatomical pathology type

Neoadjuvant CT

Organ confinement

Tumour in UUT concomitantly with BC

**Table 2.** Major Perioperative Complications, N = 563
Type	N° pacientes(% respecto a N = 563)
Major perioperative complications (< 30 days).
Early reoperation (bleeding, peritonitis, occlusion)	12	(2.1%)
Surgical	Rectal injury	5	(2.3%)
	Evisceration	8
Fistulas (with action)	Intestinal leakage	11	(2.1%)
	Enteroneovesical fistula	1
Multi-organ failure	2	(0.3%)
Infectious	Sepsis	9	(1.7%)
	Pseudomembranous colitis	1
PT	20	(3%)
Cardiological	Acute MI	2	(1.2%)
	Acute pulmonary edema	5
Neurological	CVA	1	(0.1%)
Respiratory	Respiratory failure	2	(0.5%)
	Bronchoaspiration	1
Digestive	Liver failure	3	(0.5%)
Perioperative mortality	36	(6.4%)

Table 2. Major Perioperative Complications, N = 563

Type

N° pacientes(% respecto a N = 563)

Major perioperative complications (< 30 days).

Early reoperation (bleeding, peritonitis, occlusion)

(2.1%)

Surgical

Rectal injury

(2.3%)

Evisceration

Fistulas (with action)

Intestinal leakage

(2.1%)

Enteroneovesical fistula

Multi-organ failure

(0.3%)

Infectious

Sepsis

(1.7%)

Pseudomembranous colitis

(3%)

Cardiological

Acute MI

(1.2%)

Acute pulmonary edema

Neurological

CVA

(0.1%)

Respiratory

Respiratory failure

(0.5%)

Bronchoaspiration

Digestive

Liver failure

(0.5%)

Perioperative mortality

(6.4%)

**Table 3.** Minor Perioperative Complications (< 30 Days)
Type	N° patients (% of N = 563)
Prolonged ileus	47 (8.3%)
Abscess (with action)	11 (1.9%)
Infected wound	26 (4.6%)
Urinary leak (with action)	15 (2.6%)
UTI with repercussion, pyelonephritis	10 (1.7%)
DVT	5 (0.8%)
Cardiac arrhythmia	1 (0.1%)
Pneumonia	26 (4,.6%)
Metabolic acidosis	9 (1.5%)
Upper GI bleeding	14 (2.4%)
Cholecystitis	1 (0.1%)

Table 3. Minor Perioperative Complications (< 30 Days)

Type

N° patients (% of N = 563)

Prolonged ileus

47 (8.3%)

Abscess (with action)

11 (1.9%)

Infected wound

26 (4.6%)

Urinary leak (with action)

15 (2.6%)

UTI with repercussion, pyelonephritis

10 (1.7%)

DVT

5 (0.8%)

Cardiac arrhythmia

1 (0.1%)

Pneumonia

26 (4,.6%)

Metabolic acidosis

9 (1.5%)

Upper GI bleeding

14 (2.4%)

Cholecystitis

1 (0.1%)

**Table 4.** Late-Onset Complications, N = 563
Type	N° pacientes (% de N = 563)
Repair of the derivation	In Mainz I	1	9 (1.5%)
	Hautmann neobladder repair	1
	Reparacion estoma Bricker	7
Reconversion of the derivation	To the colonic conduit	1	7 (1.2%)
	Reconversion to Bricker	6
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 occlusion	7(1.2%)
Eventration: mesh	4 (0.7%)
Parastomal hernia repair	1 (0.1%)

Table 4. Late-Onset Complications, N = 563

Type

N° pacientes (% de N = 563)

Repair of the derivation

In Mainz I

9 (1.5%)

Hautmann neobladder repair

Reparacion estoma Bricker

Reconversion of the derivation

To the colonic conduit

7 (1.2%)

Reconversion to Bricker

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 occlusion

7(1.2%)

Eventration: mesh

4 (0.7%)

Parastomal hernia repair

1 (0.1%)

**Table 5.** PFS Predictive Model
Variable	B	SE	Wald	Gl	P	O.R	95% IC para Exp (B)
Pathological organ confinement	1.077	0.283	14.445	1	0.000	2.936	1.685	5.117
Nodal involvement	0.861	0.214	16.219	1	0.000	2.365	1.556	3.595

Table 5. PFS Predictive Model

Variable

Wald

O.R

95% IC para Exp (B)

Inferior

Superior

Pathological organ confinement

1.077

0.283

14.445

0.000

2.936

1.685

5.117

Nodal involvement

0.861

0.214

16.219

0.000

2.365

1.556

3.595

**Table 6.** CSS Predictive Model
Variable	B	SE	Wald	gl	P	O.R	95% CI for Exp(B)
Pathological organ confinement	0.906	0.233	15.097	1	0.000	2.475	1.567	3.909
Nodal involvement	0.849	0.192	19.466	1	0.000	2.336	1.603	3.406

Table 6. CSS Predictive Model

Variable

Wald

O.R

95% CI for Exp(B)

Inferior

Superior

Pathological organ confinement

0.906

0.233

15.097

0.000

2.475

1.567

3.909

Nodal involvement

0.849

0.192

19.466

0.000

2.336

1.603

3.406

**Table 7.** Mortality and Morbidity in Different Series
Perioperative mortality and % of complications in radical cystectomy
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%

Table 7. Mortality and Morbidity in Different Series

Perioperative mortality and % of complications in radical cystectomy

Referentes

Mortality

Morbidity

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%