ArticleWorld journal of urology2024
The effect of hospital caseload on perioperative mortality, morbidity and costs in bladder cancer patients undergoing radical cystectomy: results of the German nationwide inpatient data.
Article in World journal of urology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 1 of them a synthesis that pooled it.
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Who cites it
14 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Efficacy and safety of male fertility-sparing radical cystectomy with orthotopic neobladder versus radical cystectomy and nerve-sparing cystectomy: a meta-analysis.Frontiers in oncology · 2025Pooled it
- Perioperative outcomes following open radical cystectomy in the setting of locally advanced bladder cancer.International urology and nephrology · 2026Observational
- Hospital caseload thresholds for improved perioperative outcomes during transurethral resection or enucleation of the prostate: results from the GRAND study.World journal of urology · 2026Article
- Evolution of treatment and oncological outcomes in patients undergoing radical cystectomy: a comparative analysis across two decades at a tertiary center.BMC urology · 2026Article
- Optimizing local control in the surgical management of bladder cancer.Nature reviews. Urology · 2026Review
- Peri-operative outcomes of open, laparoscopic and robotic simple prostatectomy.BJU international · 2025Article
- The perioperative outcomes of retroperitoneal lymph node dissection in Germany for patients with testicular cancer: Results from the GRAND study.International journal of cancer · 2025Article
- Perioperative Outcomes After Radical Nephrectomy with Inferior Vena Cava Thrombectomy.Cancers · 2025Article
- Prophylactic Use of Biologic Mesh in Ileal Conduit (PUBMIC trial).Translational andrology and urology · 2025Article
- Impact of Intraoperative Opioid Use and a Combined Anesthesia Regimen in Patients Undergoing Radical Prostatectomy for Prostate Cancer in a Single-Center Cohort.Journal of clinical medicine · 2024Article
- Radical Cystectomy with Ileal Orthotopic Neobladder after 70 Years Leads to Worse Health-Related Quality of Life.Journal of clinical medicine · 2024Article
- Article
- Urothelial cancer: state of art in Ukraine and improvement pathways.Annals of medicine and surgery (2012) · 2024Article
- The impact of perioperative risk factors on long-term survival after radical cystectomy: a prospective, high-volume cohort study.World journal of urology · 2024Article
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9 authors.
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No grant is acknowledged in the PubMed record.
Abstract
objectivesTo determine a data-based optimal annual radical cystectomy (RC) hospital volume threshold and evaluate its clinical significance regarding perioperative mortality, complications, length of hospital stay, and hospital revenues. MATERIAL AND
methodsWe used the German Nationwide inpatient Data, provided by the Research Data Center of the Federal Bureau of Statistics (2005-2020). 95,841 patients undergoing RC were included. Based on ROC analyses, the optimal RC threshold to reduce mortality, ileus, sepsis, transfusion, hospital stay, and costs is 54, 50, 44, 44, 71 and 76 cases/year, respectively. Therefore, we defined an optimal annual hospital threshold of 50 RCs/year, and we also used the threshold of 20 RCs/year proposed by the EAU guidelines to perform multiple patient-level analyses.
results28,291 (29.5%) patients were operated in low- (< 20 RC/year), 49,616 (51.8%) in intermediate- (20-49 RC/year), and 17,934 (18.7%) in high-volume (≥ 50 RC/year) centers. After adjusting for major risk factors, high-volume centers were associated with lower inpatient mortality (OR 0.72, 95% CI 0.64-0.8, p < 0.001), shorter length of hospital stay (2.7 days, 95% CI 2.4-2.9, p < 0.001) and lower costs (457 Euros, 95% CI 207-707, p < 0.001) compared to low-volume centers. Patients operated in low-volume centers developed more perioperative complications such as transfusion, sepsis, and ileus.
conclusionsCentralization of RC not only improves inpatient morbidity and mortality but also reduces hospital stay and costs. We propose a threshold of 50 RCs/year for optimal outcomes.
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