TY  - JOUR
A1  - Höh, Robert Benedikt
A1  - Flammia, Rocco Simone
A1  - Hohenhorst, Lukas
A1  - Sorce, Gabriele
A1  - Chierigo, Francesco
A1  - Panunzio, Andrea
A1  - Tian, Zhe
A1  - Saad, Fred
A1  - Gallucci, Michele
A1  - Briganti, Alberto
A1  - Terrone, Carlo
A1  - Shariat, Shahrokh F.
A1  - Graefen, Markus
A1  - Tilki, Derya
A1  - Antonelli, Alessandro
A1  - Kluth, Luis
A1  - Mandel, Philipp
A1  - Chun, Felix
A1  - Karakiewicz, Pierre I.
T1  - Effect of neoadjuvant chemotherapy on complications, in-hospital mortality, Length of stay and total hospital costs in bladder cancer patients undergoing radical cystectomy
T2  - Cancers
N2  - Background: To test for differences in complication rates, in-hospital mortality, length of stay (LOS) and total hospital costs (THCs) in patients treated with neoadjuvant chemotherapy (NAC) prior to radical cystectomy (RC). Methods: Within the National (Nationwide) Inpatient Sample (NIS) database (2016–2019), we identified RC-treated, non-metastatic, lymph-node negative bladder cancer patients, stratified by NAC status. Trend analyses, multivariable logistic, multivariable Poisson and multivariable linear regression models were used. Results: We identified 4347 RC-treated bladder cancer patients. Of those, 805 (19%) received NAC prior to RC. Overall, complications rates did not differ (65 vs. 66%; p = 0.7). However, NAC patients harbored lower rates of surgical site (6 vs. 9%), cardiac (13 vs. 19%) and genitourinary (5.5 vs. 9.7%) complications. In-hospital mortality (<1.7 vs. 1.8%) and LOS (6 vs. 7 days) was lower in NAC patients (all p < 0.05). Moreover, NAC was an independent predictor of shorter LOS in multivariable Poisson regression models (Risk ratio: 0.86; p < 0.001) and an independent predictor for higher THCs in multivariable linear regression models (Odds ratio: 1474$; p = 0.02). Conclusion: NAC was not associated with higher complication rates and in-hospital mortality. Contrary, NAC was associated with shorter LOS, yet moderately higher THCs. The current analysis suggests no detriment from NAC in the context of RC.
KW  - neoadjuvant chemotherapy
KW  - radical cystectomy
KW  - outcomes
KW  - bladder cancer
KW  - NIS
KW  - cost analysis
KW  - length of stay
Y1  - 2022
UR  - http://publikationen.ub.uni-frankfurt.de/frontdoor/index/index/docId/69291
UR  - https://nbn-resolving.org/urn:nbn:de:hebis:30:3-692910
SN  - 2072-6694
N1  - Data Availability Statement
All data generated for this study were from the National Inpatient Sample (NIS) database. The code for the analyses will be made available upon request.
VL  - 14
IS  - 5, art. 1222
SP  - 1
EP  - 12
PB  - MDPI
CY  - Basel
ER  -