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Comparing Post-operative Complication rates between Neoadjuvant Chemotherapy and Chemotherapy Na´ve 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) na´ve 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 na´ve group had at least one complication. The Clavien-Dindo classification scores were 2.39 and 2.55 for the NC and CT na´ve groups, respectively. There was a total of 347 post-operative and 90 day complications in 208 patients, or 1.73 complications per patient.

NeoadjuvantCT naive
Number of patients50158
Age (years)65.768.1
Gender41M/9F131M/27F
EBL (mL)1214898
Length of stay (days)1011.7
Follow up (months)20.827.5
OR time (minutes)422402
ASA score2.782.77
Pre-operative albumin3.874.01

Conclusions:
Patients who underwent NC had a 10.8% lower post-operative complication rate than CT na´ve 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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