[Morbidity, mortality, and overall survival after radical cystectomy: comparison of single-center results with the literature and a nomogram]. / Morbidität, Mortalität und Gesamtüberleben nach radikaler Zystektomie: Abgleich eigener Daten mit der Literatur und einem Nomogramm.

ABSTRACT

BACKGROUND: Overall survival (OS) after radical cystectomy is determined. It is investigated retrospectively whether prediction is possible using a nomogram. A comparison with published data from "high-volume" centers is performed. PATIENTS AND METHODS: Data of 100 consecutive radical cystectomies performed between 2006 and 2012 were collected. Age, ASA score, tumor stage, urinary diversion, and Clavien score were recorded. The OS after 2 and 5 years was recorded (Kaplan-Meier analysis) and the nomogram-based predictive accuracy was calculated. RESULTS: Median age was 70.8 years. A T≤2, T3, T4, N+ stage was present in 40, 37, 23, and 43%, respectively. Urinary diversion neobladder, conduit, and ureterostomy were performed in 35, 53, and 12%. The 30-day mortality was 1%. At follow-up, there were 95 patients with a median observation time of 19.8 months. The 2- and 5-year OS were 0.68 and 0.45 (Kaplan-Meier analysis) and 0.65 and 0.39, respectively (nomogram). A significant correlation was observed (rs=0.79; rs=0.80). Compared to published "high-volume" series, no relevant differences concerning morbidity, mortality, and OS were observed. However, there are significant differences concerning the characteristics of "high-volume centers". CONCLUSION: In this series, the OS can be predicted by a multivariate nomogram. The results are comparable with published data. There is no clear definition of a "high-volume center".