Analysis of gender differences in early perioperative complications following radical cystectomy at a tertiary cancer center using a standardized reporting methodology Journal Article
| Authors: | Siegrist, T.; Savage, C.; Shabsigh, A.; Cronin, A.; Donat, S. M. |
| Article Title: | Analysis of gender differences in early perioperative complications following radical cystectomy at a tertiary cancer center using a standardized reporting methodology |
| Abstract: | Objectives: Gender differences in perioperative complications following radical cystectomy (RC) are under-studied, but suggest a tendency for higher blood loss and/or transfusion in females. Variability in reporting methodologies may affect findings; therefore, we utilized a standardized reporting methodology to evaluate for gender differences in perioperative complications at a tertiary cancer center. Materials and methods: A retrospective review of the Memorial Sloan-Kettering Cancer Center (MSKCC) RC database between 1995 and 2005 was performed. All complications within 90 days of surgery were recorded and classified using a 5-grade modification of the Clavien system. Results: Of 1,142 study patients, 280 (25%) were female. Preoperatively, females were more likely to have multiple co-morbidities (39% vs. 27%, P < 0.001), a prior abdominal surgery (64% vs. 42%, P < 0.001), and to be slightly less obese than men. Females had longer operative times (mean 413 vs. 391 minutes; P = 0.005), higher blood loss (mean 1,322 cc vs. 1,151 cc, P = 0.002), and higher transfusion rates (>4 units red blood cells: 13% vs. 8%; P = 0.025). Although females were significantly more likely than males to experience a complication within 90 days of surgery (72% vs. 62%; P = 0.003); we did not find any important differences in the rate, grade, type, or timing of complications between genders. Additionally, females were less likely than males to receive a continent diversion (25% vs. 40%, P < 0.001) or a pelvic lymph node dissection (90% vs. 96%, P < 0.001). Conclusions: Females in our cohort had significantly higher blood loss, more transfusions, and a higher rate of complications. Females were also less likely to undergo a node dissection or continent diversion, for reasons not totally attributable to patient or disease characteristics, implying patient or surgeon preference played a role. © 2010 Elsevier Inc. All rights reserved. |
| Keywords: | controlled study; aged; retrospective studies; major clinical study; review; lymph node dissection; preoperative evaluation; bleeding; obesity; bladder cancer; urinary bladder neoplasms; postoperative complications; standardization; cancer center; operation duration; radical cystectomy; cystectomy; comorbidity; blood transfusion; sex difference; tertiary health care; sex factors; gender; perioperative complication; sex distribution |
| Journal Title: | Urologic Oncology: Seminars and Original Investigations |
| Volume: | 28 |
| Issue: | 1 |
| ISSN: | 1078-1439 |
| Publisher: | Elsevier Inc. |
| Date Published: | 2010-01-01 |
| Start Page: | 112 |
| End Page: | 117 |
| Language: | English |
| DOI: | 10.1016/j.urolonc.2009.04.012 |
| PUBMED: | 20123360 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | --- - "Export Date: 20 April 2011" - "CODEN: UOSOA" - "Source: Scopus" |
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