Effect of neoadjuvant chemotherapy on complications, in-hospital mortality, Length of stay and total hospital costs in bladder cancer patients undergoing radical cystectomy

  • 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.

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Author:Robert Benedikt HöhORCiDGND, Rocco Simone FlammiaORCiD, Lukas HohenhorstORCiD, Gabriele SorceORCiD, Francesco ChierigoORCiD, Andrea PanunzioORCiD, Zhe Tian, Fred SaadORCiDGND, Michele GallucciORCiD, Alberto BrigantiORCiD, Carlo TerroneORCiDGND, Shahrokh F. ShariatORCiDGND, Markus GraefenORCiDGND, Derya TilkiORCiDGND, Alessandro AntonelliORCiD, Luis KluthORCiDGND, Philipp MandelORCiDGND, Felix ChunORCiDGND, Pierre I. Karakiewicz
URN:urn:nbn:de:hebis:30:3-692910
DOI:https://doi.org/10.3390/cancers14051222
ISSN:2072-6694
Parent Title (English):Cancers
Publisher:MDPI
Place of publication:Basel
Document Type:Article
Language:English
Date of Publication (online):2022/02/26
Date of first Publication:2022/02/26
Publishing Institution:Universitätsbibliothek Johann Christian Senckenberg
Release Date:2024/05/06
Tag:NIS; bladder cancer; cost analysis; length of stay; neoadjuvant chemotherapy; outcomes; radical cystectomy
Volume:14
Issue:5, art. 1222
Article Number:1222
Page Number:12
First Page:1
Last Page:12
Note:
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.
Institutes:Medizin
Dewey Decimal Classification:6 Technik, Medizin, angewandte Wissenschaften / 61 Medizin und Gesundheit / 610 Medizin und Gesundheit
Sammlungen:Universitätspublikationen
Licence (German):License LogoCreative Commons - CC BY - Namensnennung 4.0 International