Back to 2026 Abstracts
Surgeon Impact on Radical Cystectomy Outcomes: A Two-Institution Analysis
Adam Jeffrey Cole, MD1, Randie White, MD2, Emilie Platteter, BS3, Evelyn James, BA, MPH1, Stephen Ryan, MD1, Matthew Hayn, MD1, Jesse Sammon, DO1, Vitaly Margulis, MD4, Jeffrey Howard, MD, PhD1.
1Maine Medical Center, Portland, ME, USA, 2Vanderbilt, Nashville, TN, USA, 3University of New England, Portland, ME, USA, 4University of Texas Southwestern Medical Center, Dallas, TX, USA.
BACKGROUND: Radical cystectomy (RC) is a complex procedure with high postoperative morbidity. While patients often seek care from the “best” surgeon, surgeon-specific outcomes are not well characterized. We evaluated whether individual surgeons were associated with differences in major complications or 90-day readmissions following RC.
METHODS: We conducted a retrospective review of 352 patients who underwent RC between 2015 and 2025 at a single institution, performed by five surgeons. For external validation, we analyzed a second cohort of 551 patients treated between 2016 and 2020 at a separate institution across six surgeons. Postoperative complications were graded using the Clavien-Dindo classification system. Multivariable logistic regression models assessed factors associated with major complications and 90-day readmissions, including surgeon, surgical approach, and patient characteristics. Analyses from the primary cohort were replicated in the validation cohort.
RESULTS: Surgeon identity was not associated with major complications at either institution. A robotic approach was associated with lower odds of major complications at both sites (OR 0.55, p=0.048; OR 0.41, p=0.051). However, one surgeon at each institution had higher odds of 90-day readmission (OR 3.95, p=0.004; OR 2.56, p=0.04). Robotic approach was also associated with reduced readmissions (OR 0.57, p=0.04; OR 0.38, p=0.04).
CONCLUSIONS: Surgeon identity was not associated with major complications following RC, but variation in readmission rates was observed. Robotic approach was consistently associated with improved outcomes. These findings suggest that major complications may be driven by patient and procedural factors, while differences in postoperative care may contribute to variability in readmissions.
Back to 2026 Abstracts
