Optimizing outcome reporting after radical cystectomy for organ-confined urothelial carcinoma of the bladder using oncological trifecta and pentafecta

Aziz A, Gierth M, Rink M, Schmid M, Chun FK, Dahlem R, Roghmann F, Palisaar RJ, Noldus J, Ellinger J, Mueller SC, Pycha A, Martini T, Bolenz C, Moritz R, Herrmann E, Keck B, Wullich B, Mayr R, Fritsche HM, Burger M, Bastian PJ, Seitz C, Brookman-May S, Xylinas E, Shariat SF, Fisch M, May M (2015)

Publication Type: Journal article

Publication year: 2015

Journal

World Journal of Urology Springer Verlag (Germany)

Book Volume: 33

Pages Range: 1945-50

Journal Issue: 12

DOI: 10.1007/s00345-015-1572-x

Abstract

Radical cystectomy (RC) for urothelial carcinoma of the bladder (UCB) is associated with heterogeneous functional and oncological outcomes. The aim of this study was to generate trifecta and pentafecta criteria to optimize outcome reporting after RC.We interviewed 50 experts to consider a virtual group of patients (age <= 75 years, ASA score <= 3) undergoing RC for a cT2 UCB and a final histology of <=pT3pN0M0. A ranking was generated for the three and five criteria with the highest sum score. The criteria were applied to the Prospective Multicenter Radical Cystectomy Series 2011. Multivariable binary logistic regression analyses were used to evaluate the impact of clinical and histopathological parameters on meeting the top selected criteria.The criteria with the highest sum score were negative soft tissue surgical margin, lymph node (LN) dissection of at least 16 LNs, no complications according to Clavien-Dindo grade 3-5 within 90 days after RC, treatment-free time between TUR-BT with detection of muscle-invasive UCB and RC <3 months and the absence of local UCB-recurrence in the pelvis <=12 months. The first three criteria formed trifecta, and all five criteria pentafecta. A total of 334 patients qualified for final analysis, whereas 35.3 and 29 % met trifecta and pentafecta criteria, respectively. Multivariable analyses showed that the relative probability of meeting trifecta and pentafecta decreases with higher age (3.2 %, p = 0.043 and 3.3 %, p = 0.042) per year, respectively.Trifecta and pentafecta incorporate essential criteria in terms of outcome reporting and might be considered for the improvement of standardized quality assessment after RC for UCB.

Authors with CRIS profile

Bastian Keck Medizinische Fakultät Bernd Wullich Lehrstuhl für Urologie

Involved external institutions

Klinikum St. Elisabeth Straubing GmbH DE Germany (DE) Universitätsklinikum Hamburg-Eppendorf (UKE) DE Germany (DE) Medizinische Universität Wien AT Austria (AT) University of Paris 5 - René Descartes / Université Paris V René Descartes FR France (FR) Ludwig-Maximilians-Universität (LMU) DE Germany (DE) Paracelsus-Kliniken Deutschland DE Germany (DE) Universität Regensburg DE Germany (DE) Universitätsklinikum Münster DE Germany (DE) Ruprecht-Karls-Universität Heidelberg DE Germany (DE) Zentralkrankenhaus Bozen IT Italy (IT) Universitätsklinikum Bonn DE Germany (DE) Ruhr-Universität Bochum (RUB) DE Germany (DE)

How to cite

APA:

Aziz, A., Gierth, M., Rink, M., Schmid, M., Chun, F.K., Dahlem, R.,... May, M. (2015). Optimizing outcome reporting after radical cystectomy for organ-confined urothelial carcinoma of the bladder using oncological trifecta and pentafecta. World Journal of Urology, 33(12), 1945-50. https://doi.org/10.1007/s00345-015-1572-x

MLA:

Aziz, Atiqullah, et al. "Optimizing outcome reporting after radical cystectomy for organ-confined urothelial carcinoma of the bladder using oncological trifecta and pentafecta." World Journal of Urology 33.12 (2015): 1945-50.

BibTeX: Download