Population-based analyses of radical cystectomy and urinary diversion for bladder cancer in northern Italy.

OBJECTIVE: \u2022To provide updated figures on urinary diversion, length of stay and mortality after cystectomy in two regions of northern Italy. PATIENTS AND METHODS: \u2022Discharge records of patients undergoing cystectomy for bladder cancer in 2000-2008 were extracted from the regional archives of hospital discharges. \u2022Data on partial vs radical cystectomy and type of urinary diversion were obtained from intervention codes. \u2022The influence of demographic characteristics, year of intervention, presence of comorbidities and hospital cystectomy volume on the adoption of a continent diversion and on in-hospital mortality was assessed through multilevel models. RESULTS: \u2022The crude cystectomy rate was close to 10 per 100,000. \u2022The share of partial cystectomies declined from 5.5% in 2000-2002 to 3.0% in 2006-2008. \u2022A continent diversion was adopted in 35% of radical cystectomies, with higher rates in young male patients treated in high-volume hospitals. \u2022Median length of stay declined from 20 days in 2000-2002 to 18 in 2006-2008; in-hospital mortality decreased from 3.2% to 2.2%. CONCLUSION: \u2022This first population-based report on cystectomies for bladder cancer from continental Europe evidences a limited role of partial cystectomy, a high proportion of continent diversion and a decreasing trend of length of stay and in-hospital mortality