It matters: day of week (DOW) and type of surgical assistant (SAT) (second attending [SA] vs fourth year resident [R-4] vs advanced care provider [ACP]) predict outcomes following radical cystectomy

Abstract

RESULTS: Median follow-up was 3 years (IQR 1.3-6.1). Median patient age was 69.6. A total of 200 (59%) patients had a recurrence and 14 (4.1%) had stage progression. The number of patients receiving either an ACE-I or ARB was 143. On univariate analysis, factors associated with improved RFS included cis (p1⁄40.040), bacillus Calmette-Guerin (BCG) therapy (p1⁄40.003), and ACE-I/ ARB therapy (p1⁄40.009). On multivariate analysis patients treated with BCG therapy (HR 0.68, 95% CI 0.47-0.87; p1⁄40.002) or ACE-I/ARB therapy (HR 0.61, 95% CI 0.45-0.84; p1⁄40.005), were less likely to experience tumor recurrence. The 5-year RFS rate was 45.6% (ACE-I/ARBs) and 28.1% (No ACE-I/ARBs) (p1⁄40.009). In a subgroup analysis, patients on BCG therapy alone (n1⁄485) vs BCG combined with ACE-I/ARB therapy (n1⁄452); multivariate analysis revealed that patients treated with BCG alone (HR 2.19, 95% CI 1.01-4.77; p1⁄40.04) were associated with a worse RFS compared to patients treated with BCG and ACE-I/ ARB therapy (HR 0.45, 95% CI 0.21-0.98; p1⁄40.04) for stage Ta.