التفاصيل البيبلوغرافية
| العنوان: |
Neoadjuvant chemotherapy for bladder cancer does not increase risk of perioperative morbidity. |
| المؤلفون: |
Johnson, David C., Nielsen, Matthew E., Matthews, Jonathan, Woods, Michael E., Wallen, Eric M., Pruthi, Raj S., Milowsky, Matthew I., Smith, Angela B. |
| المصدر: |
BJU International; Aug2014, Vol. 114 Issue 2, p221-228, 8p |
| مصطلحات موضوعية: |
CANCER chemotherapy, CYSTECTOMY, BLADDER cancer, INFECTION, HEALTH outcome assessment |
| مستخلص: |
Objective To determine whether neoadjuvant chemotherapy ( NAC) is a predictor of postoperative complications, length of stay ( LOS), or operating time after radical cystectomy ( RC) for bladder cancer. Patients and Methods A retrospective review of the American College of Surgeons National Surgical Quality Improvement Program ( NSQIP) database was performed to identify patients receiving NAC before RC from 2005 to 2011. Bivariable and multivariable analyses were used to determine whether NAC was associated with 30-day perioperative outcomes, e.g. complications, LOS, and operating time. Results Of the 878 patients who underwent RC for bladder cancer in our study, 78 (8.9%) received NAC. Excluding those patients who were ineligible for NAC due to renal insufficiency, 78/642 (12.1%) received NAC. In all, 457 of the 878 patients (52.1%) undergoing RC had at least one complication ≤30 days of RC, including 43 of 78 patients (55.1%) who received NAC and 414 of 800 patients (51.8%) who did not ( P = 0.58). On multivariable logistic regression, NAC was not a predictor of complications ( P = 0.87), re-operation ( P = 0.16), wound infection ( P = 0.32), or wound dehiscence ( P = 0.32). Using multiple linear regression, NAC was not a predictor of increased operating time ( P = 0.24), and patients undergoing NAC had a decreased LOS ( P = 0.02). Conclusions Our study is the first large multi-institutional analysis specifically comparing complications after RC with and without NAC. Using a nationally validated, prospectively maintained database specifically designed to measure perioperative outcomes, we found no increase in perioperative complications or surgical morbidity with NAC. Considering these findings and the well-established overall survival benefit over surgery alone, efforts are needed to improve the uptake of NAC. [ABSTRACT FROM AUTHOR] |
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| قاعدة البيانات: |
Complementary Index |
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