PD12-12 COMPLICATION RATES AFTER RADICAL CYSTECTOMY AFTER RADIOTHERAPY: AN INTERNATIONAL, MULTICENTER RETROSPECTIVE STUDY ON 609 CASES
2016-03-28

You have accessJournal of UrologyTrauma/Reconstruction/Diversion: Ureter (including Pyeloplasty) and Bladder Reconstruction (including fistula), Augmentation, Substitution, Diversion I1 Apr 2016PD12-12 COMPLICATION RATES AFTER RADICAL CYSTECTOMY AFTER RADIOTHERAPY: AN INTERNATIONAL, MULTICENTER RETROSPECTIVE STUDY ON 609 CASES Paolo Gontero, Francesca Pisano, Steven Joniau, Maarten Albersen, Antonino Battaglia, Paolo Destefanis, Renzo Colombo, Alberto Briganti, Federico Pellucchi, Giusy Burgio, Bas Van Rhijn, Elies E. Fransen Van de Putte, Salvador Esquena, Juan Palou, Marek Babjuk, Hans Martin Fritsche, Roman Mayr, Peter Albers, Guenter Niegisch, Alexandre De la Taille, Alexandra Masson-Lecomte, Morgan Roupret, Tommaso Cai, J Alfred Witjes, Max Bruins, Jack Baniel, Roy Mano, Maurizio Brausi, Alberto Lapini, Francesco Sessa, Jaques Irani, Arnulf Stenzl, Georgios Gakis, R. Jeffrey Karnes, Fabio Zattoni, Douglas Scherr, Padraic O'Malley, Shahrokh F Shariat, Peter Black, Hamidreza Abdi, Vsevolod B Matveev, Olga I Samuseva, Maria V Peters, Dipen J Parekh, Mark Gonzalgo, Aziz Atiquallah, Margit Fish, and Michael Rink Paolo GonteroPaolo Gontero More articles by this author , Francesca PisanoFrancesca Pisano More articles by this author , Steven JoniauSteven Joniau More articles by this author , Maarten AlbersenMaarten Albersen More articles by this author , Antonino BattagliaAntonino Battaglia More articles by this author , Paolo DestefanisPaolo Destefanis More articles by this author , Renzo ColomboRenzo Colombo More articles by this author , Alberto BrigantiAlberto Briganti More articles by this author , Federico PellucchiFederico Pellucchi More articles by this author , Giusy BurgioGiusy Burgio More articles by this author , Bas Van RhijnBas Van Rhijn More articles by this author , Elies E. Fransen Van de PutteElies E. Fransen Van de Putte More articles by this author , Salvador EsquenaSalvador Esquena More articles by this author , Juan PalouJuan Palou More articles by this author , Marek BabjukMarek Babjuk More articles by this author , Hans Martin FritscheHans Martin Fritsche More articles by this author , Roman MayrRoman Mayr More articles by this author , Peter AlbersPeter Albers More articles by this author , Guenter NiegischGuenter Niegisch More articles by this author , Alexandre De la TailleAlexandre De la Taille More articles by this author , Alexandra Masson-LecomteAlexandra Masson-Lecomte More articles by this author , Morgan RoupretMorgan Roupret More articles by this author , Tommaso CaiTommaso Cai More articles by this author , J Alfred WitjesJ Alfred Witjes More articles by this author , Max BruinsMax Bruins More articles by this author , Jack BanielJack Baniel More articles by this author , Roy ManoRoy Mano More articles by this author , Maurizio BrausiMaurizio Brausi More articles by this author , Alberto LapiniAlberto Lapini More articles by this author , Francesco SessaFrancesco Sessa More articles by this author , Jaques IraniJaques Irani More articles by this author , Arnulf StenzlArnulf Stenzl More articles by this author , Georgios GakisGeorgios Gakis More articles by this author , R. Jeffrey KarnesR. Jeffrey Karnes More articles by this author , Fabio ZattoniFabio Zattoni More articles by this author , Douglas ScherrDouglas Scherr More articles by this author , Padraic O'MalleyPadraic O'Malley More articles by this author , Shahrokh F ShariatShahrokh F Shariat More articles by this author , Peter BlackPeter Black More articles by this author , Hamidreza AbdiHamidreza Abdi More articles by this author , Vsevolod B MatveevVsevolod B Matveev More articles by this author , Olga I SamusevaOlga I Samuseva More articles by this author , Maria V PetersMaria V Peters More articles by this author , Dipen J ParekhDipen J Parekh More articles by this author , Mark GonzalgoMark Gonzalgo More articles by this author , Aziz AtiquallahAziz Atiquallah More articles by this author , Margit FishMargit Fish More articles by this author , and Michael RinkMichael Rink More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2016.02.907AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Conflicting evidence exists on the complication rates after cystectomy following previous radiotherapy with only a few, mostly single institution, available series. The aim of this study was to assess the complication rate of radical cystectomy (RC) carried out after previous radiotherapy (RT) for abdominal-pelvic malignances. METHODS Patients treated with RC for benign or malignant disease following any previous history of RT (administered to the abdomen, pelvis or perineum) and with available information on complications for a minimum of 1 year were entered in a multicenter database. Patients with prior RT for any urological, hematological, gynecological and gastrointestinal malignancy were eligible. RESULTS 609 patients (median follow-up 17months) with a median age of 71years underwent RT (78% EBRT) for prostate, bladder (BC), gynecological (cervical, uterine, vulvar) or other cancers in 52%, 24%, 10% and 14%, respectively. RC was performed for BC, any other cancer or non cancer reasons in 62.9%, 11.5% and 25.6% respectively (median time from RT to RC: 57 months). Overall 455 (74.7%) pts. had at least one complication after RC, with 200 (44%) pts. having a major complication (Clavien grade =3) and 19 (4.2%) pts. experiencing a fatal complication. At least one surgical complication occurred in 315 (51.7%) pts., which was major in half of cases. Most common specific surgical complications were hemorrhage (14.3%), wound dehiscence (9.5%), ureteric stricture (8.9%) and bowel leakage (5.7%), respectively. A medical complication was observed in 317 (52.1%) pts., with overall 67 (21.1%) experiencing a major complication. Renal failure and paralytic ileus each occurred in 12% of cases. Patients treated with RT for bladder cancer had a 1.7 times increased relative risk of experiencing any complication after secondary RC compared to pts. with RT for prostate cancer (p=0.042) in multivariable logistic regression analysis adjusted for age, gender and type of RT. CONCLUSIONS RC after previous RT carries a high major complication rate that, contrary to previous reports, dramatically exceeds that reported in RT-naïve RCs. Patients undergoing such procedure should be counseled accordingly. © 2016FiguresReferencesRelatedDetails Volume 195Issue 4SApril 2016Page: e297 Advertisement Copyright & Permissions© 2016MetricsAuthor Information Paolo Gontero More articles by this author Francesca Pisano More articles by this author Steven Joniau More articles by this author Maarten Albersen More articles by this author Antonino Battaglia More articles by this author Paolo Destefanis More articles by this author Renzo Colombo More articles by this author Alberto Briganti More articles by this author Federico Pellucchi More articles by this author Giusy Burgio More articles by this author Bas Van Rhijn More articles by this author Elies E. Fransen Van de Putte More articles by this author Salvador Esquena More articles by this author Juan Palou More articles by this author Marek Babjuk More articles by this author Hans Martin Fritsche More articles by this author Roman Mayr More articles by this author Peter Albers More articles by this author Guenter Niegisch More articles by this author Alexandre De la Taille More articles by this author Alexandra Masson-Lecomte More articles by this author Morgan Roupret More articles by this author Tommaso Cai More articles by this author J Alfred Witjes More articles by this author Max Bruins More articles by this author Jack Baniel More articles by this author Roy Mano More articles by this author Maurizio Brausi More articles by this author Alberto Lapini More articles by this author Francesco Sessa More articles by this author Jaques Irani More articles by this author Arnulf Stenzl More articles by this author Georgios Gakis More articles by this author R. Jeffrey Karnes More articles by this author Fabio Zattoni More articles by this author Douglas Scherr More articles by this author Padraic O'Malley More articles by this author Shahrokh F Shariat More articles by this author Peter Black More articles by this author Hamidreza Abdi More articles by this author Vsevolod B Matveev More articles by this author Olga I Samuseva More articles by this author Maria V Peters More articles by this author Dipen J Parekh More articles by this author Mark Gonzalgo More articles by this author Aziz Atiquallah More articles by this author Margit Fish More articles by this author Michael Rink More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...