title: Oncological and functional outcomes of postoperative total parenteral nutrition after radical cystectomy in bladder cancer patients: A single-center randomized trial.
abstract: To prospectively evaluate the long-term oncological and functional outcomes of postoperative total parenteral nutrition after radical cystectomy.
  
  
  
  A total of 157 consecutive patients (≤cT3, cN0, cM0) who underwent extended pelvic lymph node dissection, radical cystectomy and ileal urinary diversion from September 2008 to March 2011 at a single center were randomized to receive either postoperative total parenteral nutrition (group A; n = 74) or oral nutrition alone (group B; n = 83). All but two patients in group B (who were thus excluded from further analysis) had regular postoperative follow up at the Department of Urology, University of Bern, Switzerland. Computed tomography and bone scan were carried out to assess local recurrences and distal metastases. We used validated questionnaires to evaluate bowel function, sexual function and quality of life, and an institutional questionnaire to evaluate neobladder function.
  
  
  
  The median follow up was 50 months (IQR 21-62). The rate of local recurrences (4/74 [5.4%] in group A; 4/81 [4.9%] in group B; P = 0.9) and the rate of distant metastases (23/74 [31%] in group A; 23/81 [28%] in group B; P = 0.72) did not differ between the two groups. There was no difference in cancer-specific (P = 0.86) and overall survival (P = 0.85). Group B patients had significantly better bowel function at 3 months (P = 0.03) and 12 months (P = 0.01). There was no difference in terms of quality of life, and sexual and neobladder function.
  
  
  
  The administration of total parenteral nutrition after radical cystectomy does not impair long-term oncological outcomes. It does, however, negatively influence long-term bowel function.
authors: Department of Urology, University of Bern, Bern, Switzerland.|Faculty of Medicine, University of Chile, Santiago, Chile.
authors: Alvaro
authors: A
authors: Vidal
authors: Department of Urology, University of Bern, Bern, Switzerland.
authors: Nicolas
authors: N
authors: Arnold
authors: Department of Urology, University of Bern, Bern, Switzerland.|Department of Cell and Molecular Biology, University of Medicine and Pharmacy, Târgu-Mureş, Romania.
authors: Mihai Dorin
authors: MD
authors: Vartolomei
authors: Department of Urology, University of Bern, Bern, Switzerland.
authors: Bernhard
authors: B
authors: Kiss
authors: Department of Urology, University of Bern, Bern, Switzerland.
authors: Fiona
authors: F
authors: Burkhard
authors: Department of Urology, University of Bern, Bern, Switzerland.
authors: George N
authors: GN
authors: Thalmann
authors: Department of Urology, University of Bern, Bern, Switzerland.
authors: Beat
authors: B
authors: Roth
mesh_terms: D015653:Cystectomy; D006801:Humans; D009364:Neoplasm Recurrence, Local; D010289:Parenteral Nutrition, Total; D011183:Postoperative Complications; D011788:Quality of Life; D016896:Treatment Outcome; D001749:Urinary Bladder Neoplasms / Q000601:surgery*; D014547:Urinary Diversion
keywords: bladder cancer; cystectomy; functional outcomes; oncological outcomes; parenteral nutrition