Department of Urology, Skåne University Hospital, Malmö, Sweden.
Institution of Translational Medicine, Lund University, Malmö, Sweden.
Scand J Urol. 2021 Aug;55(4):276-280. doi: 10.1080/21681805.2021.1938665. Epub 2021 Jun 14.
For patients undergoing radical cystectomy for bladder cancer, a procedure requiring complex urinary tract reconstruction prone to major postoperative complications, the timing and quality of the surgery have been associated with outcomes.
This study investigated if radical cystectomy for bladder cancer performed during holiday periods had worse disease-specific (DSS) and overall survival (OS), higher 90-day mortality and risk of readmissions. All patients operated on with radical cystectomy for primary bladder cancer during 1997-2014 with holiday periods as exposure (with one narrow (7 weeks) and one wider (14 weeks) definition) in the Swedish population-based bladder cancer research-database (BladderBaSe) were studied. DSS and OS after radical cystectomy during holiday periods were analysed with Cox regression models adjusted for sex, age, comorbidity, marital status, T-stage and nodal metastases, neoadjuvant chemotherapy, hospital volume and year of cystectomy.
Surgery during the holiday periods (narrow and wide definitions) were not associated with DSS (Hazard ratio [HR] = 1.05, 95% confidence interval [95% CI] = 0.90-1.21 and HR = 1.04, 95% CI = 0.91-1.17), respectively. HRs for OS were similar, and no associations between radical cystectomy during any of the holiday period definitions and 90-day mortality and readmission were found.
Survival after radical cystectomy in Sweden is similar during holiday and non-holiday periods.
对于因膀胱癌而行根治性膀胱切除术的患者，该手术需要进行复杂的尿路重建，容易发生重大术后并发症，手术的时机和质量与结局相关。
本研究调查了在假期期间进行的膀胱癌根治性切除术是否会导致更差的疾病特异性（DSS）和总体生存（OS），更高的 90 天死亡率和再入院风险。在瑞典基于人群的膀胱癌研究数据库（BladderBaSe）中，对 1997 年至 2014 年间接受根治性膀胱切除术治疗原发性膀胱癌的所有患者进行了研究，将假期（有一个较窄的（7 周）和一个较宽的（14 周）定义）作为暴露因素。使用 Cox 回归模型，根据性别、年龄、合并症、婚姻状况、T 分期和淋巴结转移、新辅助化疗、医院容量和膀胱切除术年份，对假期期间进行根治性膀胱切除术的患者进行 DSS 和 OS 分析。
假期期间（窄和宽定义）的手术与 DSS 无关（危险比[HR]分别为 1.05，95%置信区间[95%CI]为 0.90-1.21 和 HR = 1.04，95%CI = 0.91-1.17）。OS 的 HR 相似，并且在任何假期定义下进行根治性膀胱切除术与 90 天死亡率和再入院之间均无关联。
在瑞典，假期和非假期期间进行根治性膀胱切除术的生存情况相似。
