Pd38-05 Delineating the Interplay of Cumulative 90-Day Morbidity and Health-Related Quality of Life After Radical Cystectomy—prospective Evidence From the Compact Registry

You have accessJournal of UrologyBladder Cancer: Invasive IV (PD38)1 May 2024PD38-05 DELINEATING THE INTERPLAY OF CUMULATIVE 90-DAY MORBIDITY AND HEALTH-RELATED QUALITY OF LIFE AFTER RADICAL CYSTECTOMY—PROSPECTIVE EVIDENCE FROM THE COMPACT REGISTRY Mara Koelker, Sandra Trepte, Hanna Kukuk, Daniel Stelzl, Jakob Klemm, Markus von Deimling, Roland Dahlem, Margit Fisch, and Malte W. Vetterlein Mara KoelkerMara Koelker , Sandra TrepteSandra Trepte , Hanna KukukHanna Kukuk , Daniel StelzlDaniel Stelzl , Jakob KlemmJakob Klemm , Markus von DeimlingMarkus von Deimling , Roland DahlemRoland Dahlem , Margit FischMargit Fisch , and Malte W. VetterleinMalte W. Vetterlein View All Author Informationhttps://doi.org/10.1097/01.JU.0001009424.64728.0c.05AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Little is known about the interplay of perioperative complication burden and patient-reported quality of life after radical cystectomy (RC). We aimed to delineate this association leveraging the Comprehensive Outcome Measures and Perioperative Morbidity After CystecTomy (COMPACT) study (DRKS00024929). METHODS: COMPACT is a prospective assessment of perioperative complications and patient-reported outcomes measures (PROMs). 90-day morbidity was assessed according to the EAU guidelines of standardized reporting using both Clavien-Dindo classification (CDC) and Comprehensive Complication Index (CCI), mirroring cumulative morbidity on a scale from 0-100. Endpoint was health-related quality of life (HRQOL) and was assessed using the Functional Assessment of Cancer Therapy – Bladder – Cystectomy (FACT-Bl-Cys) total score (range 0-168) at 6 months postoperatively in patients undergoing open RC with pelvic lymph node dissection between 2020-2022. Linear regression analyses were employed for the main endpoint using A) 90-day CDC grade ≤IIIa vs. ≥IIIb and B) 90-day CCI as predictors (adjusted for age-adjusted Charlson comorbidity index ACCI, sex, BMI, urinary diversion, and ≤pT2N0 vs. ≥pT3 and/or N+). RESULTS: Of 105 patients who underwent RC, 82 (78%) had PROMs available at all time points at baseline, 3, 6, 9, and 12 months postoperatively. Among the 90-day complications, 47 (57%) were classified as CDC grade I-II, 22 (27%) as CDC grade III, and 11 (13%) as CDC grade IV, with a 90-day mortality rate (CDC grade V) of 1.2%. Median 90-day CCI was 34 (IQR 24-44) and median 6-month FACT-Bl-Cys total score was 118 (IQR 90-142). In linear regression analysis, ACCI was significantly associated with the 6-month FACT-Bl-Cys total score (coefficient: -4.85, p=0.013). However, neither 90-day CDC grade nor 90-day CCI demonstrated a significant association with 6-month HRQOL (all p>0.05). These findings were confirmed in sensitivity analyses evaluating the 9- and 12-month FACT-Bl-Cys total scores. CONCLUSIONS: Perioperative morbidity is high after RC, especially when using rigorous reporting standards. However, most patients experience minor events within 90 days. Remarkably, higher perioperative morbidity burden, measured by the highest grade (CDC) or by cumulative morbidity (CCI), did not adversely affect HRQOL at 6 months. This provides reassurance to surgeons and patients and valuable guidance for counseling by offering a comprehensive understanding of the procedure's overall impact. Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e808 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Mara Koelker More articles by this author Sandra Trepte More articles by this author Hanna Kukuk More articles by this author Daniel Stelzl More articles by this author Jakob Klemm More articles by this author Markus von Deimling More articles by this author Roland Dahlem More articles by this author Margit Fisch More articles by this author Malte W. Vetterlein More articles by this author Expand All Advertisement PDF downloadLoading ...