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Comparing Post-operative Complication rates between Neoadjuvant Chemotherapy and Chemotherapy Naïve Patients who undergo Cystectomy for Bladder Cancer
Jack W Lambert, III, Stephen Riggs, Matthew Ingham, Bethany Barone
EVMS, Norfolk, VA
Introduction:
Although it may appear implicit that patients who receive neoadjuvant chemotherapy (NC) for bladder cancer would have higher complication rates post-operatively, there has been sparse literature published on this subject. Our single institution study compares complication rates between NC and chemotherapy (CT) naïve patients who underwent radical cystectomy (RC).
Methods:
We performed a retrospective review from our bladder cancer database of 208 patients and we included any patient from 2004-2011 who underwent cystectomy for bladder cancer. 13 patients were excluded from analysis because they died prior to cystectomy. Immediate post-operative and 90 day complications were recorded for all patients.
Results:
Interestingly, 60.5% of patients in the NC group and 71.3% in chemotherapy naïve group had at least one complication. The Clavien-Dindo classification scores were 2.39 and 2.55 for the NC and CT naïve groups, respectively. There was a total of 347 post-operative and 90 day complications in 208 patients, or 1.73 complications per patient. | | | | Neoadjuvant | CT naive | | Number of patients | 50 | 158 | | Age (years) | 65.7 | 68.1 | | Gender | 41M/9F | 131M/27F | | EBL (mL) | 1214 | 898 | | Length of stay (days) | 10 | 11.7 | | Follow up (months) | 20.8 | 27.5 | | OR time (minutes) | 422 | 402 | | ASA score | 2.78 | 2.77 | | Pre-operative albumin | 3.87 | 4.01 |
Conclusions:
Patients who underwent NC had a 10.8% lower post-operative complication rate than CT naïve patients. Therefore, in our single institution study NC does not confer an increased complication risk and the potential risk for complications should not deter urologists from the pursuing this option for patients.
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