You have accessJournal of UrologyBladder Cancer: Invasive II1 Apr 2015MP58-17 CASE-LOAD IS NOT ASSOCIATED WITH SURGICAL OUTCOMES OF RADICAL CYSTECTOMY. A NATION-WIDE STUDY OF CURRENT PRACTICE Borja Lopez, Carlos Llorente, Virginia Hernández, Enrique De la Peña, Elia Pérez-Fernández, and Maria A. Gogorcena Borja LopezBorja Lopez More articles by this author , Carlos LlorenteCarlos Llorente More articles by this author , Virginia HernándezVirginia Hernández More articles by this author , Enrique De la PeñaEnrique De la Peña More articles by this author , Elia Pérez-FernándezElia Pérez-Fernández More articles by this author , and Maria A. GogorcenaMaria A. Gogorcena More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.02.2156AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Surgeon- and hospital-case volume are identified as factors related with outcomes of surgical procedures. Radical cystectomy (RC), due to its major impact on the patient, might substantially benefit from centralization if this assumption were true. We aim to test this hypothesis in Spain, a country in which no lower limit nor centralization for radical cystectomy exists. METHODS We performed a retrospective cohort review of patients undergoing RC in Spain during 2011 and 2012, accessing data from inpatient discharge forms (CMBD) of every patient operated on of radical cystectomy. CMBD is a mandatory file that is submitted to the Ministry of Health and provides information on patient's demographics as well as morbidity and cause of discharge including death. Hospitals were stratified into volume quartiles depending on their 2-year cumulative cystectomy volume (very low- volume <22; low- volume 22-41; medium -volume 42-58 and high-volume>58). Hospitals were also categorized according to their size in beds and teaching facilities. A comparison with data in the literature was made. RESULTS We analyzed 5,594 RCs in 266 centers of Spain during 2011 and 2012 (2,701 RCs in 2011 and 2,893 RCs in 2012). Mean age was 66.5±9.8 years and 84.7% were males. Mean hospital stay was 20.7±16.6 days. Mortality rate at 30, 60 and 90 days was 2.8%, 4.7% and 5.9%, respectively. 90-day mortality rate for very-low, low, medium and high-volume centers was 5.9%, 5.9%, 7% and 5.1%, respectively (p=0.2). Hospital size and teaching facilities were not associated with mortality. A statistically significant difference was noted in the complications and readmission rate. These results compare favorably with reported multicenter series in the literature with 90-day mortality rate ranging from 4.2 to 7.9%. CONCLUSIONS Our data do not support an urgent need for regionalization of radical cystectomy in our country. However, initiatives to improve surgical outcomes of radical cystectomy within individual national setting should be explored. © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 193Issue 4SApril 2015Page: e728 Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.MetricsAuthor Information Borja Lopez More articles by this author Carlos Llorente More articles by this author Virginia Hernández More articles by this author Enrique De la Peña More articles by this author Elia Pérez-Fernández More articles by this author Maria A. Gogorcena More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...