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Intraoperative complication of radical cystectomy for muscle-invasive bladder cancer: does the surgical approach matter? A retrospective multicenter study using the EAUiaiC classification

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Abstract

Purpose

Despite surgical and anesthetic progress, radical cystectomy for bladder cancer remains one of the most morbid surgeries in urology. The objective of our study was to describe intraoperative complications and to assess the impact of surgical approach on morbidity.

Methods

We retrospectively reviewed medical records of patients treated by radical cystectomy for localized muscle invasive bladder cancer between 2015 and 2020, following the Martin et al. criteria for complications reports. All intraoperative adverse events were graded according to the EAUiaiC scores. Multivariate regression models were used to determine predicting factors of complications.

Results

A total of 318 patients were included for analysis. Among them, 17 patients (5.4%) presented an intraoperative complication. No preoperative oncological or clinical factor was associated with the occurrence of an intraoperative complication. Surgical approach had no impact on morbidity. Both overall survival (HR 2.02; CI95% 0.87–4.68; p = 0.101) and recurrence-free survival (HR 1.856; CI95% 0.804–4.284; p = 0.147) were not associated with intraoperative complication.

Conclusion

Radical cystectomy remains a highly morbid surgery and surgical approach did not improve the complication rate. Perioperative morbidity has a significant impact on patient survival. The association between intraoperative and postoperative complications illustrates the cumulative effect of perioperative events that are associated with survival.

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Data availability

The data that support the findings of this study are available from the corresponding author, ID, upon reasonable request.

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Authors and Affiliations

  1. Department of Urology, APHP, Cochin Hospital, Paris Cité Université, 75014, Paris, France

    Igor Duquesne, Michael Peyromaure & Nicolas Barry Delongchamps

  2. Departement of Urology, Geneva University Hospitals, Geneva, Switzerland

    Daniel Benamran

  3. Department of Urology, APHP, Saint Louis Hospital, Paris Cité University, 75010, Paris, France

    Alexandra Masson-Lecomte

  4. Department of Urology, APHP, Mondor Hospital, Paris Est Créteil University, 94000, Créteil, France

    Alexandre De La Taille

  5. Department of Urology, APHP, Pitié-Salpêtrière Hospital, Sorbonne University, 75013, Paris, France

    Morgan Rouprêt

Authors
  1. Igor Duquesne
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  2. Daniel Benamran
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  3. Alexandra Masson-Lecomte
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  4. Alexandre De La Taille
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  5. Michael Peyromaure
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  6. Morgan Rouprêt
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  7. Nicolas Barry Delongchamps
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Contributions

ID: participated in research design, data collection, writing of the paper, performance of the research, data analysis. DB: participated in data collection. AM-L: participated in data collection. ADLT: participated in research design, manuscript editing. MP: participated in research design, manuscript editing. MR: participated in research design, project development, manuscript writing and editing. NBD: participated in research design, manuscript writing and editing.

Corresponding author

Correspondence to Igor Duquesne.

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Conflict of interest

Authors have no conflict of interest to disclose. MR is proctor for Intuitive.

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For this study oral consent was obtained for every patient.

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Duquesne, I., Benamran, D., Masson-Lecomte, A. et al. Intraoperative complication of radical cystectomy for muscle-invasive bladder cancer: does the surgical approach matter? A retrospective multicenter study using the EAUiaiC classification. World J Urol 41, 1061–1067 (2023). https://doi.org/10.1007/s00345-023-04340-z

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  • DOI: https://doi.org/10.1007/s00345-023-04340-z

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