Improved surgical outcomes following radical cystectomy at high-volume centers influence overall survival

Positive surgical margins (PSM) and lymph node yield (LNY) following radical cystectomy (RC) for urothelial carcinoma of the bladder affect survival. Variations in PSM or LNY at different care facilities are poorly described. We evaluated the relationship between hospital surgical volume and academi...

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Bibliographic Details
Published in:Urologic oncology 2018-06, Vol.36 (6), p.308.e11-308.e17
Main Authors: Scarberry, Kyle, Berger, Nicholas G., Scarberry, Kelly B., Agrawal, Shree, Francis, John J., Yih, Jessica M., Gonzalez, Christopher M., Abouassaly, Robert
Format: Article
Language:English
Subjects:
Aged
Cohort Studies
Cystectomy
Cystectomy - mortality
Female
Follow-Up Studies
Hospitals, High-Volume - statistics & numerical data
Humans
Male
Margins of excision
Middle Aged
Outcomes
Prognosis
Regionalization
Survival Rate
Urinary Bladder Neoplasms - mortality
Urinary Bladder Neoplasms - pathology
Urinary Bladder Neoplasms - surgery
Volume
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Summary:Positive surgical margins (PSM) and lymph node yield (LNY) following radical cystectomy (RC) for urothelial carcinoma of the bladder affect survival. Variations in PSM or LNY at different care facilities are poorly described. We evaluated the relationship between hospital surgical volume and academic hospital status with these surgical outcomes and overall survival (OS). Patients with nonmetastatic urothelial carcinoma of the bladder who underwent RC were identified from the National Cancer Database (2004–2013). Treatment centers were categorized as academic (ACC) and community cancer centers (CCC). Logistic regression was used to identify factors associated with PSM status and LNY, and a multivariate Cox proportional hazards model was used to determine factors associated with OS. In our cohort, 39,274 patients underwent RC. A lower proportion of PSMs (10% vs.12%; P
ISSN:1078-1439
1873-2496
DOI:10.1016/j.urolonc.2018.03.007