[Morbidity, mortality, and overall survival after radical cystectomy: comparison of single-center results with the literature and a nomogram].
BACKGROUND
Overall survival (OS) after radical cystectomy is determined. It is investigated retrospectively whether prediction is possible using a nomogram. A comparison with published data from "high-volume" centers is performed.


METHODS
Data of 100 consecutive radical cystectomies performed between 2006 and 2012 were collected. Age, ASA score, tumor stage, urinary diversion, and Clavien score were recorded. The OS after 2 and 5 years was recorded (Kaplan-Meier analysis) and the nomogram-based predictive accuracy was calculated.


RESULTS
Median age was 70.8 years. A T≤2, T3, T4, N+ stage was present in 40, 37, 23, and 43%, respectively. Urinary diversion: neobladder, conduit, and ureterostomy were performed in 35, 53, and 12%. The 30-day mortality was 1%. At follow-up, there were 95 patients with a median observation time of 19.8 months. The 2- and 5-year OS were 0.68 and 0.45 (Kaplan-Meier analysis) and 0.65 and 0.39, respectively (nomogram). A significant correlation was observed (rs=0.79; rs=0.80). Compared to published "high-volume" series, no relevant differences concerning morbidity, mortality, and OS were observed. However, there are significant differences concerning the characteristics of "high-volume centers".


CONCLUSIONS
In this series, the OS can be predicted by a multivariate nomogram. The results are comparable with published data. There is no clear definition of a "high-volume center".
Abteilung Urologie, Asklepios Klinik St. Georg, Lohmühlenstraße 5, 20099, Hamburg, Deutschland, cl.brunken@asklepios.com.
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Brunken
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Tauber
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Wohlmuth
D000368:Aged; D015653:Cystectomy / Q000401:mortality*; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D008137:Longitudinal Studies; D008297:Male; D049451:Nomograms; D016016:Proportional Hazards Models; D018570:Risk Assessment; D015996:Survival Rate; D001749:Urinary Bladder Neoplasms / Q000401:mortality* / Q000601:surgery*