title: Performance of partial cystectomy in the United States from 2001 to 2010: trends and comparative outcomes.
abstract: BACKGROUND
  To investigate the trends in the performance of radical cystectomy (RC) versus partial cystectomy (PC) in the United States over the past 10 years and compare postoperative outcomes between two procedures.
  
  
  METHODS
  The data was captured from the Nationwide Inpatient Sample (NIS) 2001-2010 using the appropriate ICD-9-CM diagnosis and procedure codes. Patient sociodemographics, comorbidities and in-hospital complications after PC and RC were compared, taking into account some hospital characteristics. A chi-square analysis including a Cochran-Armitage trend test and a multivariable logistic regression analysis were employed.
  
  
  RESULTS
  RC rate increased from 84.8% in 2001 to 90.3% in 2010, while PC decreased from 15.2% to 9.7% (p < 0.0001). PC patients were older than their RC counterparts (72.1 ± 11.3 versus 68.6 ± 10.1 years; p < 0.0001), had higher prevalence of major comorbidities, but decreased rate of postoperative complications overall (21.3% versus 38.6%; p < 0.001). The greatest rates of PC utilization were found in the Northeast and South (12.8% and 12.7%). The frequency of PC was 18.9% in non-teaching hospitals compared to 9.0% in teaching hospitals (p < 0.0001). In multivariate analysis, females, octogenarians, patients with hypertension and obesity, and patients in non-teaching and rural hospitals were more likely to receive PC.
  
  
  CONCLUSIONS
  Despite the potential advantages in cancer control offered by RC, PC is being performed more frequently on the elderly, female patients, patients with hypertension and obesity, in non-teaching and rural hospitals, and in certain United States geographic regions, which can be partially explained by disparities in access to high volume cancer centers.
authors.affiliation: Section of Urologic Oncology, Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey, USA.
authors.forename: Izak
authors.initials: I
authors.lastname: Faiena
authors.forename: Viktor
authors.initials: V
authors.lastname: Dombrovskiy
authors.forename: Christopher
authors.initials: C
authors.lastname: Koprowski
authors.forename: Eric A
authors.initials: EA
authors.lastname: Singer
authors.forename: Thomas L
authors.initials: TL
authors.lastname: Jang
authors.forename: Robert E
authors.initials: RE
authors.lastname: Weiss
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D015653:Cystectomy / Q000009:adverse effects / Q000379:methods* / Q000639:trends*; D005260:Female; D006801:Humans; D015994:Incidence; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology; D012189:Retrospective Studies; D012737:Sex Factors; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology; D001749:Urinary Bladder Neoplasms / Q000453:epidemiology* / Q000601:surgery*