Mp41-05 chronic kidney disease and radical cystectomy for bladder cancer: perioperative and oncologic outcomes in 1,214 patients

You have accessJournal of UrologyBladder Cancer: Invasive II (MP41)1 Sep 2021MP41-05 CHRONIC KIDNEY DISEASE AND RADICAL CYSTECTOMY FOR BLADDER CANCER: PERIOPERATIVE AND ONCOLOGIC OUTCOMES IN 1,214 PATIENTS Charles Nguyen, Saum Ghodoussipour, Matthew Winter, Giovanni Cacciamani, Hamed Ahmadi, Hooman Djaladat, Anne Schuckman, Siamak Daneshmand, Monish Aron, Inderbir Gill, and Mihir Desai Charles NguyenCharles Nguyen More articles by this author , Saum GhodoussipourSaum Ghodoussipour More articles by this author , Matthew WinterMatthew Winter More articles by this author , Giovanni CacciamaniGiovanni Cacciamani More articles by this author , Hamed AhmadiHamed Ahmadi More articles by this author , Hooman DjaladatHooman Djaladat More articles by this author , Anne SchuckmanAnne Schuckman More articles by this author , Siamak DaneshmandSiamak Daneshmand More articles by this author , Monish AronMonish Aron More articles by this author , Inderbir GillInderbir Gill More articles by this author , and Mihir DesaiMihir Desai More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002062.05AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: To assess the impact of chronic kidney disease (CKD) on outcomes after radical cystectomy (RC) and pelvic lymph node dissection in patients with bladder cancer treated within a high-volume tertiary referral center. METHODS: A total of 1,214 patients underwent RC with intent to cure from 2009 to 2019 as identified from our prospectively collated institutional database. The Modification of Diet in Renal Disease (MDRD) GFR (mL/min/1.73 m2) was calculated and the entire cohort was categorized by baseline GFR: Group A = GFR >60 (Normal), Group B = GFR >30-59 (Stage 3 CKD) and Group C = GFR <30 (Stage 4 CKD). Pre-, intra- and postoperative characteristics, oncological outcomes, and 90-day perioperative outcomes were compared. Multivariable logistic regression was used to control for confounding variables. RESULTS: We identified 722 (59.5%) patients in Group A, 448 (36.9%) in Group B and 44 (3.6%) in Group C. Patients with worse CKD were older and had significantly worse overall comorbidity (all p <0.001). On univariate analysis, worse CKD was associated with higher pathologic stage, lymph node metastases and positive soft tissue margins (all p <0.0001). The rates of blood transfusion, 90-day complications and readmissions were higher in patients with worse CKD (p <0.0001, p=0.02, p=0.04, respectively). Patients with worse CKD had worse overall survival (77% vs 73% vs 55%, p <0.0001). On multivariable analysis, worse CKD was independently associated with adverse pathology (≥pT3 or node positive) (OR=6.96, 95%CI 3.20-15.12), 90-day readmissions (OR 2.09, 95%CI 1.11-3.94) and perioperative transfusion (OR 2.08, 95%CI 1.05-4.11). CONCLUSIONS: CKD is prevalent in patients undergoing radical cystectomy. We found CKD to be independently associated with a higher likelihood of adverse pathology, 90-day readmissions, and transfusion. Source of Funding: None © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e761-e761 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Charles Nguyen More articles by this author Saum Ghodoussipour More articles by this author Matthew Winter More articles by this author Giovanni Cacciamani More articles by this author Hamed Ahmadi More articles by this author Hooman Djaladat More articles by this author Anne Schuckman More articles by this author Siamak Daneshmand More articles by this author Monish Aron More articles by this author Inderbir Gill More articles by this author Mihir Desai More articles by this author Expand All Advertisement Loading ...