Aims: Radical cystectomy is a complex uro-oncological surgical procedure with high surgical morbidity. We examined outcomes for patients diagnosed with bladder cancer who underwent a radical cystectomy (RC).
Methods: Data was extracted from the Queensland Oncology Repository (QOR). The cohort included all patients diagnosed with bladder cancer between 2002 and 2016 in Queensland who underwent a radical cystectomy (total excision). Hospitals were categorised as high (>7 RCs/year) and low (≤7 RCs/year). Outcomes included 30-day and 90-day mortality and 2-year overall survival. Follow-up time was up to 31 December 2018.
Results: A total of 7403 patients diagnosed with bladder cancer were diagnosed during the fifteen-year period. 1230 patients underwent a radical cystectomy. Overall 77% were male and median age was 67 years. In-hospital mortality was 1.1%, and 30- and 90-day mortality was 1.4% and 2.9%, respectively. Both 30- and 90-day mortality was significantly higher for older versus younger patients (P = 0.01 and P < 0.001, respectively). Patients treated more recently were about 80% less likely to die within 90 days (OR=0.24, 95%CI 0.09-0.59) (P=0.008). Two-year overall survival was 71.5%, with significant improvements observed over time (P < 0.001). There was no difference in post-operative mortality or survival for patients treated in low compared to high volume hospitals.
Conclusions: In Queensland there are low post-operative mortality rates overall, with rates decreasing significantly over time. Examining post-operative outcomes, and survival over time will assist in helping monitor clinical progress and identify areas for improvement for patients diagnosed with bladder cancer.