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A Personalized Approach to Radical Cystectomy Can Decrease Its Complication Rates

The aim of this study was to assess the influence of a patient’s general status on perioperative morbidity and mortality after radical cystectomy, and to assess which of the used scales is best for the prediction of major complications. The data of 331 patients with muscle-invasive bladder cancer, w...

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Autores principales: Adamczyk, Przemyslaw, Poblocki, Pawel, Michalik, Cyprian, Kadlubowski, Mateusz, Adamowicz, Jan, Mikolajczak, Witold, Drewa, Tomasz, Juszczak, Kajetan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8878982/
https://www.ncbi.nlm.nih.gov/pubmed/35207768
http://dx.doi.org/10.3390/jpm12020281
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author Adamczyk, Przemyslaw
Poblocki, Pawel
Michalik, Cyprian
Kadlubowski, Mateusz
Adamowicz, Jan
Mikolajczak, Witold
Drewa, Tomasz
Juszczak, Kajetan
author_facet Adamczyk, Przemyslaw
Poblocki, Pawel
Michalik, Cyprian
Kadlubowski, Mateusz
Adamowicz, Jan
Mikolajczak, Witold
Drewa, Tomasz
Juszczak, Kajetan
author_sort Adamczyk, Przemyslaw
collection PubMed
description The aim of this study was to assess the influence of a patient’s general status on perioperative morbidity and mortality after radical cystectomy, and to assess which of the used scales is best for the prediction of major complications. The data of 331 patients with muscle-invasive bladder cancer, who underwent radical cystectomy, were analyzed. The general status was assessed according to the American Society of Anesthesiologists (ASA), Charlson Comorbidity Index (CCI), Eastern Cooperative Oncology Group (ECOG), and Geriatric-8 (G-8) scales. Complications were classified according to the Clavien–Dindo classification system. In a group of patients with the highest complication rate according to the Clavien–Dindo scale, (i) statistically more patients rated high according to the ASA and ECOG scales, (ii) patients had significantly higher CCI scores (minor complications (I-II), and (iii) there were significantly more patients rated as frail with G8—predominantly those with 11 points or fewer in the scale. A patient’s general status should be assessed before the start of therapy because patients with a high risk of death or serious complications (evaluated with any rating scale) should be offered conservative treatment. None of the scales can describe the risk of cystectomy, because the percentage of patients with major complications among those who achieved worse score results on any scale was not significantly different from the percentage of patients with major complications in the general group.
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spelling pubmed-88789822022-02-26 A Personalized Approach to Radical Cystectomy Can Decrease Its Complication Rates Adamczyk, Przemyslaw Poblocki, Pawel Michalik, Cyprian Kadlubowski, Mateusz Adamowicz, Jan Mikolajczak, Witold Drewa, Tomasz Juszczak, Kajetan J Pers Med Article The aim of this study was to assess the influence of a patient’s general status on perioperative morbidity and mortality after radical cystectomy, and to assess which of the used scales is best for the prediction of major complications. The data of 331 patients with muscle-invasive bladder cancer, who underwent radical cystectomy, were analyzed. The general status was assessed according to the American Society of Anesthesiologists (ASA), Charlson Comorbidity Index (CCI), Eastern Cooperative Oncology Group (ECOG), and Geriatric-8 (G-8) scales. Complications were classified according to the Clavien–Dindo classification system. In a group of patients with the highest complication rate according to the Clavien–Dindo scale, (i) statistically more patients rated high according to the ASA and ECOG scales, (ii) patients had significantly higher CCI scores (minor complications (I-II), and (iii) there were significantly more patients rated as frail with G8—predominantly those with 11 points or fewer in the scale. A patient’s general status should be assessed before the start of therapy because patients with a high risk of death or serious complications (evaluated with any rating scale) should be offered conservative treatment. None of the scales can describe the risk of cystectomy, because the percentage of patients with major complications among those who achieved worse score results on any scale was not significantly different from the percentage of patients with major complications in the general group. MDPI 2022-02-14 /pmc/articles/PMC8878982/ /pubmed/35207768 http://dx.doi.org/10.3390/jpm12020281 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Adamczyk, Przemyslaw
Poblocki, Pawel
Michalik, Cyprian
Kadlubowski, Mateusz
Adamowicz, Jan
Mikolajczak, Witold
Drewa, Tomasz
Juszczak, Kajetan
A Personalized Approach to Radical Cystectomy Can Decrease Its Complication Rates
title A Personalized Approach to Radical Cystectomy Can Decrease Its Complication Rates
title_full A Personalized Approach to Radical Cystectomy Can Decrease Its Complication Rates
title_fullStr A Personalized Approach to Radical Cystectomy Can Decrease Its Complication Rates
title_full_unstemmed A Personalized Approach to Radical Cystectomy Can Decrease Its Complication Rates
title_short A Personalized Approach to Radical Cystectomy Can Decrease Its Complication Rates
title_sort personalized approach to radical cystectomy can decrease its complication rates
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8878982/
https://www.ncbi.nlm.nih.gov/pubmed/35207768
http://dx.doi.org/10.3390/jpm12020281
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