Journal ArticleDOI
Influence of Body Mass Index on Clinical Outcome Parameters, Complication Rate and Survival after Radical Cystectomy: Evidence from a Prospective European Multicentre Study.
Michael Gierth,Florian Zeman,Stefan Denzinger,Malte W. Vetterlein,Margit Fisch,Patrick J. Bastian,Isabella Syring,Jörg Ellinger,S.C. Müller,Edwin Herrmann,Christian Gilfrich,Matthias May,Armin Pycha,Florian M.E. Wagenlehner,Stefan Vallo,Georg Bartsch,Axel Haferkamp,Marc-Oliver Grimm,Jan Roigas,Chris Protzel,Oliver W. Hakenberg,Hans-Martin Fritsche,Maximilian Burger,Atiqullah Aziz,Roman Mayr +24 more
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TLDR
There is no evidence of correlation between obesity and worse oncological outcomes after RC, and obesity should not be a parameter to exclude patients from cystectomy, but surgical settings need to be aware of higher short-term complication risks and obese patients should be counselled accordingly.Abstract:
Background/Aims/Objectives: To evaluate the influence of body mass index (BMI) on complications and oncological outcomes in patients undergoing radical cystectomy (RC). Methods: Clinical and histopathological parameters of pa-tients have been prospectively collected within the "PRO-spective MulticEnTer RadIcal Cystectomy Series 2011". BMI was categorized as normal weight ( = 25-29.9 kg/m(2)) and obesity (>= 30 kg/m(2)). The association between BMI and clinical and histopathological endpoints was examined. Ordinal logistic regression models were applied to assess the influence of BMI on complication rate and survival. Results: Data of 671 patients were eligible for final analysis. Of these patients, 26% (n = 175) showed obesity. No significant association of obesity on tumour stage, grade, lymph node metastasis, blood loss, type of urinary diversion and 90-day mortality rate was found. According to the American Society of Anesthesiologists score, local lymph node (NT) stage and operative case load patients with higher BMI had significantly higher probabilities of severe complications 30 days after RC (p = 0.037). The overall survival rate of obese patients was superior to normal weight patients (p = 0.019). Conclusions: There is no evidence of correlation between obesity and worse oncological outcomes after RC. While obesity should not be a parameter to exclude patients from cystectomy, surgical settings need to be aware of higher short-term complication risks and obese patients should be counselled - accordingly. (C) 2018 S. Karger AG, Baselread more
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Journal ArticleDOI
The impact of preoperative nutritional status on post-surgical complication and mortality rates in patients undergoing radical cystectomy for bladder cancer: a systematic review of the literature
Paola Irene Ornaghi,Luca Afferi,Alessandro Antonelli,Maria Angela Cerruto,Katia Odorizzi,Alessandra Gozzo,Livio Mordasini,Agostino Mattei,Philipp Baumeister,Julian Cornelius,Alessandro Tafuri,Marco Moschini +11 more
TL;DR: High BMI, hypoalbuminemia, and sarcopenia significantly increased the complication rate after radical cystectomy for bladder cancer and predicted worse 3 year overall survival and 5 year CSS and OS.
Journal ArticleDOI
In-Hospital Outcomes after Radical Cystectomy for Bladder Cancer: Comparing National Trends in the United States and Germany from 2006 to 2014.
Christer Groeben,Rainer Koch,Martin Baunacke,Angelika Borkowetz,Manfred P. Wirth,Johannes Huber +5 more
TL;DR: Higher patient age and lower annual hospital caseload were associated with increased mortality and longer LOS, and minimal-invasive surgery was associated with less blood transfusion and shorter LOS in the United States vs. Germany, raising the question of centralization of RC.
Journal ArticleDOI
Association between blood pressure and BMI with bladder cancer risk and mortality in 340,000 men in three Swedish cohorts
Stanley Teleka,Sylvia H J Jochems,Christel Häggström,Christel Häggström,Angela M. Wood,Bengt Järvholm,Marju Orho-Melander,Fredrik Liedberg,Tanja Stocks +8 more
TL;DR: In this article, the relation between obesity, blood pressure (BP) and mortality remains unclear, partially due to potential confounding by smoking, the strongest risk factor for BC, and not accounting for tumor stage and grade in such studies.
Journal ArticleDOI
The comprehensive complication index is associated with a significant increase in complication severity between 30 and 90 days after radical cystectomy for bladder cancer.
Maximilian Haas,Toni Huber,Christoph Pickl,Bas W.G. van Rhijn,Miodrag Gužvić,Michael Gierth,Johannes Breyer,Maximilian Burger,Roman Mayr +8 more
TL;DR: The cumulative morbidity (CCI) after RC seems to be higher than previously reported with CDC, especially over a 90-day period, and the CCI is an appropriate assessment-tool with an upgrade in morbidity in a significant proportion of patients when compared to the CDC.
Journal ArticleDOI
Different models for prediction of radical cystectomy postoperative complications and care pathways
Jacob Taylor,Xiaosong Meng,Audrey Renson,Angela B. Smith,James S. Wysock,Samir S. Taneja,William C. Huang,Marc A. Bjurlin +7 more
TL;DR: Predicting complications and factors leading to extended length of hospital stay and discharge to a higher level of care after radical cystectomy performs modestly, highlighting both the complex cyStectomy process and the limitations of large healthcare datasets.
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