title: Impact of stage and comorbidities on five-year survival after radical cystectomy in Poland: single centre experience.
abstract: BACKGROUND
  Long-term outcomes of patients treated for invasive bladder cancer in Poland are poorly documented in the literature. Impact of various clinical parameters on their survival is even less well studied. Radical cystectomy is a major surgery, so the patients' condition can be equally important as cancer stage. The aim of the study was to assess 5-year overall survival (OS) after cystectomy and impact of comorbidity on OS in a single Polish academic centre.
  
  
  METHODS
  Clinical data of all patients who underwent cystectomy in years 2004-2006 for urothelial cancer were retrospectively reviewed. Survival status was determined at least 5 years after surgery. Pathological variables, comorbidities, surgery delay and complications were evaluated as potential predictors of OS. Kaplan-Meier estimates of the survival function as well as Cox proportional hazards models were utilized.
  
  
  RESULTS
  Thirty-day, 1-year and 5-year OS for 63 patients was 98.4%, 58.7% and 31.7%, respectively. None of the investigated parameters were significantly related to five-year OS. However, a composite parameter consisting of stage, diabetes status and postoperative course was found as a significant predictor. Five-year OS in 16 patients with pT1-2 and without diabetes and without post-operative complications was higher than in the remaining 47 patients (56% vs. 23%; P = 0.02).
  
  
  CONCLUSIONS
  Five-year OS in our group was lower than in most published international series but concordant with a previous Polish report. Improvement in survival after radical cystectomy may be expected when early diagnosis will be accompanied by optimal care of patients with diabetes mellitus and avoidance of postoperative complications.
authors.affiliation: Department of Urology, Medical University of Warsaw, Poland.
authors.forename: Bartosz
authors.initials: B
authors.lastname: Dybowski
authors.affiliation: Department of Urology, Medical University of Warsaw, Poland.
authors.forename: Krzysztof
authors.initials: K
authors.lastname: Ossoliński
authors.affiliation: Department of Urology, Medical University of Warsaw, Poland.
authors.forename: Anna
authors.initials: A
authors.lastname: Ossolińska
authors.affiliation: Department of Urology, Medical University of Warsaw, Poland.
authors.forename: Michał
authors.initials: M
authors.lastname: Peller
authors.affiliation: Department of Urology, Medical University of Warsaw, Poland.
authors.forename: Ewa
authors.initials: E
authors.lastname: Bres-Niewada
authors.affiliation: Department of Urology, Medical University of Warsaw, Poland.
authors.forename: Piotr
authors.initials: P
authors.lastname: Radziszewski
keywords: bladder cancer; cystectomy; diabetes mellitus; lymphadenectomy; postoperative complications; survival