title: Radical cystectomy: do we need standardization?
abstract: The first series of radical cystectomy with a definition of surgical landmarks was published in 1949 and was characterized by a high perioperative mortality and a 5-year survival rate around 50%. Decades later, nevertheless many surgical progresses were made and the perioperative mortality dropped to 2,5%, this had not lead to an improvement of long term survival rates, also because a standardization of the procedure is still missing. Areas covered: Radical cystectomy is performed with different surgical techniques obmitting a standardization. The comparability of many studies is therefore difficult or havely compromised. A paragon with other diciplines was made emphazing that there high surgical quality is defined, measured and controlled. A systematic literature search was made selecting finally 76 article adressing this issue. Expert commentary: Surgical guidelines in uro-oncology are vague and a definition of surgical quality is missing. A view outside of the box could be very helpful. This is a plea for a change.
authors.affiliation: a Department of Urology , General Hospital of Bolzano , Bolzano , Italy.
authors.forename: Christian
authors.initials: C
authors.lastname: Ladurner
authors.affiliation: a Department of Urology , General Hospital of Bolzano , Bolzano , Italy.
authors.forename: Evi
authors.initials: E
authors.lastname: Comploj
authors.affiliation: a Department of Urology , General Hospital of Bolzano , Bolzano , Italy.
authors.forename: Emanuela
authors.initials: E
authors.lastname: Trenti
authors.affiliation: a Department of Urology , General Hospital of Bolzano , Bolzano , Italy.
authors.forename: Salvatore
authors.initials: S
authors.lastname: Palermo
authors.affiliation: b Department of Urology , Riga Stradins University , Riga , Latvia.
authors.forename: Alexander
authors.initials: A
authors.lastname: Pycha
authors.affiliation: a Department of Urology , General Hospital of Bolzano , Bolzano , Italy.|c Department of Urology , Sigmund Freud University, Medical School , Vienna , Austria.
authors.forename: Armin
authors.initials: A
authors.lastname: Pycha
mesh_terms: D015653:Cystectomy / Q000592:standards*; D006801:Humans; D059035:Perioperative Period; D011183:Postoperative Complications / Q000453:epidemiology / Q000517:prevention & control*; D017410:Practice Guidelines as Topic; D015996:Survival Rate; D001749:Urinary Bladder Neoplasms / Q000473:pathology / Q000601:surgery*
keywords: Radical cystectomy; checklist; guidelines; lymph node dissection; prostate sparing cystectomy; standardization; surgical quality