The Use of Neobladders in Patients Undergoing Radical Cystectomy in Canada
CUA Online Library. Vigil H. 06/25/13; 31330; MP-07.17
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Abstract
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The Use of Neobladders in Patients Undergoing Radical Cystectomy in Canada
Purpose/Objective: To determine the use of neobladder urinary reconstruction in Canada.
Methods: We reviewed a historical cohort of patients undergoing radical cystectomy for urothelial carcinoma at 8 academic institutions in Canada. In addition to type of urinary diversion, pre-operative patient characteristics included age, gender, Charleson
comorbidity index, tumour stage, year of surgery, and geographic region of surgery.
Results: Between 1998 and 2008, 2287 patients underwent cystectomy and 1800 had complete information on type of urinary diversion performed. Overall, urinary reconstruction was an ileal conduit in 1500 (83%), a neobladder in 280 (16%) and continent cutaneous diversion in 20 (1%). Compared to ileal conduit patients, neobladder patients were younger (57±9 vs. 68±9; p=0.01), more likely male (17% of males vs. 10% of females; p=0.001), had fewer comorbidities (Charleson 3.6 vs. 5.0; p=0.07), and had lower clinical tumour stage (T-stage >2, 6% vs 14%; p<0.001). The proportion of neobladders performed in Canada remained stable over time (<2000 = 15% vs. 2000-2003 = 16% vs. >2003 = 16%; p=0.45). Geographic location of the treating institution was significantly associated with choice of neobladder (Eastern Canada 43%, Western Canada 44%, and Central Canada 13%; p<0.01).
Conclusions: In Canada, use of neobladder urinary reconstruction is low. Patient factors associated with neobladder reconstruction may not necessarily predict neobladder function and should be analyzed. The reasons for neobladder underutilization and geographic disparity also require further study.
Purpose/Objective: To determine the use of neobladder urinary reconstruction in Canada.
Methods: We reviewed a historical cohort of patients undergoing radical cystectomy for urothelial carcinoma at 8 academic institutions in Canada. In addition to type of urinary diversion, pre-operative patient characteristics included age, gender, Charleson
comorbidity index, tumour stage, year of surgery, and geographic region of surgery.
Results: Between 1998 and 2008, 2287 patients underwent cystectomy and 1800 had complete information on type of urinary diversion performed. Overall, urinary reconstruction was an ileal conduit in 1500 (83%), a neobladder in 280 (16%) and continent cutaneous diversion in 20 (1%). Compared to ileal conduit patients, neobladder patients were younger (57±9 vs. 68±9; p=0.01), more likely male (17% of males vs. 10% of females; p=0.001), had fewer comorbidities (Charleson 3.6 vs. 5.0; p=0.07), and had lower clinical tumour stage (T-stage >2, 6% vs 14%; p<0.001). The proportion of neobladders performed in Canada remained stable over time (<2000 = 15% vs. 2000-2003 = 16% vs. >2003 = 16%; p=0.45). Geographic location of the treating institution was significantly associated with choice of neobladder (Eastern Canada 43%, Western Canada 44%, and Central Canada 13%; p<0.01).
Conclusions: In Canada, use of neobladder urinary reconstruction is low. Patient factors associated with neobladder reconstruction may not necessarily predict neobladder function and should be analyzed. The reasons for neobladder underutilization and geographic disparity also require further study.
The Use of Neobladders in Patients Undergoing Radical Cystectomy in Canada
Purpose/Objective: To determine the use of neobladder urinary reconstruction in Canada.
Methods: We reviewed a historical cohort of patients undergoing radical cystectomy for urothelial carcinoma at 8 academic institutions in Canada. In addition to type of urinary diversion, pre-operative patient characteristics included age, gender, Charleson
comorbidity index, tumour stage, year of surgery, and geographic region of surgery.
Results: Between 1998 and 2008, 2287 patients underwent cystectomy and 1800 had complete information on type of urinary diversion performed. Overall, urinary reconstruction was an ileal conduit in 1500 (83%), a neobladder in 280 (16%) and continent cutaneous diversion in 20 (1%). Compared to ileal conduit patients, neobladder patients were younger (57±9 vs. 68±9; p=0.01), more likely male (17% of males vs. 10% of females; p=0.001), had fewer comorbidities (Charleson 3.6 vs. 5.0; p=0.07), and had lower clinical tumour stage (T-stage >2, 6% vs 14%; p<0.001). The proportion of neobladders performed in Canada remained stable over time (<2000 = 15% vs. 2000-2003 = 16% vs. >2003 = 16%; p=0.45). Geographic location of the treating institution was significantly associated with choice of neobladder (Eastern Canada 43%, Western Canada 44%, and Central Canada 13%; p<0.01).
Conclusions: In Canada, use of neobladder urinary reconstruction is low. Patient factors associated with neobladder reconstruction may not necessarily predict neobladder function and should be analyzed. The reasons for neobladder underutilization and geographic disparity also require further study.
Purpose/Objective: To determine the use of neobladder urinary reconstruction in Canada.
Methods: We reviewed a historical cohort of patients undergoing radical cystectomy for urothelial carcinoma at 8 academic institutions in Canada. In addition to type of urinary diversion, pre-operative patient characteristics included age, gender, Charleson
comorbidity index, tumour stage, year of surgery, and geographic region of surgery.
Results: Between 1998 and 2008, 2287 patients underwent cystectomy and 1800 had complete information on type of urinary diversion performed. Overall, urinary reconstruction was an ileal conduit in 1500 (83%), a neobladder in 280 (16%) and continent cutaneous diversion in 20 (1%). Compared to ileal conduit patients, neobladder patients were younger (57±9 vs. 68±9; p=0.01), more likely male (17% of males vs. 10% of females; p=0.001), had fewer comorbidities (Charleson 3.6 vs. 5.0; p=0.07), and had lower clinical tumour stage (T-stage >2, 6% vs 14%; p<0.001). The proportion of neobladders performed in Canada remained stable over time (<2000 = 15% vs. 2000-2003 = 16% vs. >2003 = 16%; p=0.45). Geographic location of the treating institution was significantly associated with choice of neobladder (Eastern Canada 43%, Western Canada 44%, and Central Canada 13%; p<0.01).
Conclusions: In Canada, use of neobladder urinary reconstruction is low. Patient factors associated with neobladder reconstruction may not necessarily predict neobladder function and should be analyzed. The reasons for neobladder underutilization and geographic disparity also require further study.
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