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Urol Int ; 99(4): 429-435, 2017.
Artículo en Inglés | MEDLINE | ID: mdl-28641294

RESUMEN

INTRODUCTION AND OBJECTIVES: Bladder cancer is characterized by gender-dependent disparities. To further address this issue, we analysed a prospective, multicentre cystectomy registry. METHODS: An online database was developed that included patient demographics, intra/perioperative data, surgical data and in-house complications. RESULTS: Four hundred fifty-eight patients (112 [24.5%] women and 346 [75.5%] men) were analysed. Men and women were comparable regarding age (mean 68 years), body mass index (mean 26.5) and the mean Charlson score (4.8). Women had more advanced tumour-stages (pT3/pT4; women: 57.1%; men: 48.1%). The rate of incontinent urinary diversion was higher in women (83.1%) than in men (60.2%) and in a multivariate analysis, the strongest predictors were M+ status (OR 11.2), female gender (OR 6.9) and age (OR 6.5). Women had a higher intraoperative blood transfusion rate. The overall rate of in-house complications was similar in both genders (men: 32.0%, women: 32.6%). Severe (Clavien-Dindo grade >2) medical (women: 6.3%; men: 5.2%) and surgical (women: 21.5%; men: 14.4%) in-house complications, however, were more frequent in women. CONCLUSIONS: This multicentre registry demonstrates several gender-related differences in patients undergoing radical cystectomy. The higher transfusion rate, the rare use of orthotopic bladder substitutes and the higher in-house complication rate underline the higher complexity of this procedure in women.


Asunto(s)
Toma de Decisiones Clínicas , Cistectomía/efectos adversos , Disparidades en Atención de Salud , Complicaciones Posoperatorias/etiología , Neoplasias de la Vejiga Urinaria/cirugía , Derivación Urinaria/efectos adversos , Anciano , Austria , Distribución de Chi-Cuadrado , Bases de Datos Factuales , Femenino , Humanos , Modelos Logísticos , Masculino , Persona de Mediana Edad , Análisis Multivariante , Estadificación de Neoplasias , Oportunidad Relativa , Selección de Paciente , Estudios Prospectivos , Sistema de Registros , Factores de Riesgo , Factores Sexuales , Factores de Tiempo , Resultado del Tratamiento , Neoplasias de la Vejiga Urinaria/patología , Derivación Urinaria/métodos
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