ArticleJapanese journal of clinical oncology2023
Impact of postoperative complications on long-term survival in bladder cancer patients.
Article in Japanese journal of clinical oncology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed, 7 citations in OpenAlex.
- Real-world implementation of robot-assisted radical cystectomy at four Japanese institutions: perioperative outcomes, major complications, and mortality.Journal of robotic surgery · 2026Article
- Complication profiling in ureteroscopy: A prospective multicenter comparison of the Clavien-Dindo classification and the comprehensive complication index.Urolithiasis · 2026Article
- The impact of perioperative risk factors on long-term survival after radical cystectomy: a prospective, high-volume cohort study.World journal of urology · 2024Article
- Analysis of postoperative complications in bladder cancer patients.Open medicine (Warsaw, Poland) · 2024Article
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Authors and funding
26 authors at 16 institutions in 1 country.
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No grant is acknowledged in the PubMed record.
Abstract
objectiveTo determine the impact of postoperative complications on long-term survival outcomes in patients with bladder cancer undergoing radical cystectomy.
methodsThis retrospective multi-institutional study included 766 bladder cancer patients who underwent radical cystectomy between 2011 and 2017. Patient characteristics, perioperative outcomes, all complications within 90 days after surgery and survival outcomes were collected. Each complication was graded based on the Clavien-Dindo system, and grouped using a standardized grouping method. The Comprehensive Complication Index, which incorporates all complications into a single formula weighted by their severity, was utilized. Overall survival and recurrence-free survival (local, distant or urothelial recurrences) were stratified by Comprehensive Complication Index (high: ≥26.2; low: <26.2). A multivariate model was utilized to identify independent prognostic factors.
resultsThe incidence of any and major complications (≥Clavien-Dindo grade III) was 70 and 24%, respectively. In terms of Comprehensive Complication Index, 34% (261/766) of the patients had ≥26.2. Patients with Comprehensive Complication Index ≥ 26.2 had shorter overall survival (4-year, 59.5 vs. 69.8%, respectively, log-rank test, P = 0.0037) and recurrence free survival (51.9 vs. 60.1%, respectively, P = 0.0234), than those with Comprehensive Complication Index < 26.2. The Cox multivariate model identified the age, performance status, pT-stage, pN-stage and higher CCI (overall survival: HR = 1.35, P = 0.0174, recurrence-free survival: HR = 1.26, P = 0.0443) as independent predictors of both overall survivial and recurrence-free survival.
conclusionsPostoperative complications assessed by Comprehensive Complication Index had adverse effects on long-term survival outcomes. Physicians should be aware that major postoperative complications can adversely affect long-term disease control.
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