AUA 2017: Preoperative Risk Factors Predicting Postoperative Complications In Radical Cystectomy For Bladder Cancer

Boston, MA (UroToday.com) Studies have shown that radical cystectomy results in postoperative complication in 30%-57% and mortality of 2-5% of the cases. Dr. Glazyrine presented a study analyzing the preoperative risk factors associated with postoperative complications in RC with the main goal of designing a nomogram predicting increased risk of postoperative complications. This study specifically looked at potential preoperative predictors of postoperative complications at 30 and 90 days postoperatively.

The study population included 516 patients from a single institution, who underwent radical cystectomy for bladder cancer from 2008-2016. Potential preoperative risk predictors were collected from medical history, TURBT pathology, preoperative labs, proposed procedure type, and prior treatments. Postoperative complications were graded using the Clavien-Dindo scale and multivariate logistic regression models were used to predict post-operative complications.

Of all the potential preoperative risk factors, 16 unique predictors were determined to have strong association with 90 day postoperative complications, yielding an AUC of 0.91. After cross validation, a nomogram with a max AUC of 0.66 was created.

This study shows that routinely collected preoperative patient-level clinical variables may be useful for determining patient risk for short-term postoperative complications. The nomogram created in this study can help identify at risk patients, allowing the medical community to develop appropriate patient education, counseling and development of risk reduction strategies.

Presented By: Vassili Glazyrine, Kansas city, KS

Written By: Hanan Goldberg, MD, Urologic Oncology Fellow (SUO), University of Toronto, Princess Margaret Cancer Centre

at the 2017 AUA Annual Meeting - May 12 - 16, 2017 – Boston, Massachusetts, USA

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