caa a22 4500 445333871 CHVBK 20180317142746.0 cr unu---uuuuu 170323e20110901xx s 000 0 eng 10.1245/s10434-011-1618-2 doi (NATIONALLICENCE)springer-10.1245/s10434-011-1618-2 Surgical Caseload is an Important Determinant of Continent Urinary Diversion Rate at Radical Cystectomy: A Population-Based Study [Elektronische Daten] [Firas Abdollah, Maxine Sun, Jan Schmitges, Rodolphe Thuret, Orchidee Djahangirian, Claudio Jeldres, Zhe Tian, Shahrokh Shariat, Paul Perrotte, Francesco Montorsi, Pierre Karakiewicz] Background: At radical cystectomy (RC), continent urinary diversion (CUD) provides functional outcomes that most closely approximate that of a native bladder. We tested the hypothesis that patients treated at high RC caseload hospitals and/or by high RC caseload surgeons have higher CUD rates. Methods: We identified 9,493 bladder cancer patients treated with RC between 1998 and 2007, within the Nationwide Inpatient Sample. Univariable and multivariable analyses tested the relationship between hospital and surgical caseload at RC, and CUD rate. Generalized estimating equations models were used to adjust for clustering among hospitals and surgeons. Results: Only 8% of patients received a CUD at RC. The CUD rate was 5 vs. 7 vs. 13% for low versus intermediate versus high annual hospital caseload (AHC) tertiles (P<0.001). The CUD rate was 6 vs. 10 vs. 16% for low versus intermediate versus high annual surgical caseload (ASC) tertiles (P<0.001). In multivariable analyses, and after adjusting for clustering, ASC emerged as independent predictors of CUD rate (P<0.001), while AHC failed to achieve the independent predictor status for the same end point (P≥0.1). Conclusions: Our findings indicate that CUD is performed in a minority (8%) of RC patients. Surgical caseload represents an important determinant of CUD rate, while hospital caseload failed to achieve independent predictor status. Efforts should be made to optimize CUD rate a RC. Society of Surgical Oncology, 2011 Abdollah Firas Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Centre, Montreal, Canada aut Sun Maxine Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Centre, Montreal, Canada aut Schmitges Jan Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Centre, Montreal, Canada aut Thuret Rodolphe Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Centre, Montreal, Canada aut Djahangirian Orchidee Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Centre, Montreal, Canada aut Jeldres Claudio Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Centre, Montreal, Canada aut Tian Zhe Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Centre, Montreal, Canada aut Shariat Shahrokh Department of Urology, Weill Medical College of Cornell University, New York, NY, USA aut Perrotte Paul Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Centre, Montreal, Canada aut Montorsi Francesco Department of Urology, Vita Salute San Raffaele University, Milan, Italy aut Karakiewicz Pierre Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Centre, Montreal, Canada aut Annals of Surgical Oncology Springer-Verlag 18/9(2011-09-01), 2680-2687 1068-9265 18:9<2680 2011 18 10434 https://doi.org/10.1245/s10434-011-1618-2 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1245/s10434-011-1618-2 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Abdollah Firas Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Centre, Montreal, Canada aut NATIONALLICENCE 700 1- Sun Maxine Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Centre, Montreal, Canada aut NATIONALLICENCE 700 1- Schmitges Jan Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Centre, Montreal, Canada aut NATIONALLICENCE 700 1- Thuret Rodolphe Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Centre, Montreal, Canada aut NATIONALLICENCE 700 1- Djahangirian Orchidee Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Centre, Montreal, Canada aut NATIONALLICENCE 700 1- Jeldres Claudio Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Centre, Montreal, Canada aut NATIONALLICENCE 700 1- Tian Zhe Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Centre, Montreal, Canada aut NATIONALLICENCE 700 1- Shariat Shahrokh Department of Urology, Weill Medical College of Cornell University, New York, NY, USA aut NATIONALLICENCE 700 1- Perrotte Paul Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Centre, Montreal, Canada aut NATIONALLICENCE 700 1- Montorsi Francesco Department of Urology, Vita Salute San Raffaele University, Milan, Italy aut NATIONALLICENCE 700 1- Karakiewicz Pierre Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Centre, Montreal, Canada aut NATIONALLICENCE 773 0- Annals of Surgical Oncology Springer-Verlag 18/9(2011-09-01), 2680-2687 1068-9265 18:9<2680 2011 18 10434 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer