Contemporary rates of adherence to international guidelines for pelvic lymph node dissection in radical cystectomy: a population-based study

E Zaffuto, Marco Bandini, S Gazdovich, AS Valiquette, SR Leyh-Bannurah, Z Tian, Paolo Dell’Oglio, M Graefen, M Moschini, A Necchi, SF Shariat, A Briganti, F Montorsi, PI Karakiewicz

Research output: Contribution to journalArticle

Abstract

Objective: To examine the rates of adherence to guidelines for pelvic lymph node dissection (PLND) in patients treated with radical cystectomy (RC) and to identify predictors of omitting PLND. Materials and methods: We relied on 66,208 patients treated with RC between 2004 and 2013 within the National Inpatients Sample (NIS) database. We examined the rates of PLND according to year of surgery, patient and hospital characteristics. Univariate and multivariate logistic regression analyses assessed the probability of PLND use, after adjusting for year of surgery, age, gender, race, comorbidities, hospital location, teaching status and hospital surgical volume. Results: Overall, PLND was performed on 54,223 (81.9%) RC patients. The rates PLND at RC significantly increased over the study period from 72.3% in 2004 to 85.9% in 2013, (p < 0.001). Barriers to PLND at RC consisted of female gender (OR: 1.31; 95% CI 1.25–1.38; p < 0.001), African American race (OR: 1.21; 95% CI 1.10–1.32; p < 0.001), intermediate (OR: 1.78; 95% CI 1.68–1.88; p < 0.001) or low surgical volume institutions (OR: 2.59; 95% CI 2.44–2.74; p < 0.001), non-teaching institution status (OR: 1.21; 95% CI 1.15–1.27; p < 0.001) and rural hospital location (OR: 1.13; 95% CI 1.01–1.25; p = 0.03). Conclusions: It is encouraging to note increasing rates of PLND at RC over time. Both patients and hospital characteristics influence PLND rates. More efforts should be aimed at reducing inequalities in PLND at RC due to these highly modifiable variables. © 2018 Springer-Verlag GmbH Germany, part of Springer Nature
Original languageEnglish
Pages (from-to)1417-1422
Number of pages6
JournalWorld Journal of Urology
Volume36
Issue number9
DOIs
Publication statusPublished - 2018

Fingerprint

Cystectomy
Lymph Node Excision
Guidelines
Population
Guideline Adherence
Rural Hospitals
Teaching Hospitals
African Americans
Germany
Comorbidity
Inpatients
Logistic Models
Regression Analysis
Databases

Cite this

Zaffuto, E., Bandini, M., Gazdovich, S., Valiquette, AS., Leyh-Bannurah, SR., Tian, Z., ... Karakiewicz, PI. (2018). Contemporary rates of adherence to international guidelines for pelvic lymph node dissection in radical cystectomy: a population-based study. World Journal of Urology, 36(9), 1417-1422. https://doi.org/10.1007/s00345-018-2306-7

Contemporary rates of adherence to international guidelines for pelvic lymph node dissection in radical cystectomy: a population-based study. / Zaffuto, E; Bandini, Marco; Gazdovich, S; Valiquette, AS; Leyh-Bannurah, SR; Tian, Z; Dell’Oglio, Paolo; Graefen, M; Moschini, M; Necchi, A; Shariat, SF; Briganti, A; Montorsi, F; Karakiewicz, PI.

In: World Journal of Urology, Vol. 36, No. 9, 2018, p. 1417-1422.

Research output: Contribution to journalArticle

Zaffuto, E, Bandini, M, Gazdovich, S, Valiquette, AS, Leyh-Bannurah, SR, Tian, Z, Dell’Oglio, P, Graefen, M, Moschini, M, Necchi, A, Shariat, SF, Briganti, A, Montorsi, F & Karakiewicz, PI 2018, 'Contemporary rates of adherence to international guidelines for pelvic lymph node dissection in radical cystectomy: a population-based study', World Journal of Urology, vol. 36, no. 9, pp. 1417-1422. https://doi.org/10.1007/s00345-018-2306-7
Zaffuto, E ; Bandini, Marco ; Gazdovich, S ; Valiquette, AS ; Leyh-Bannurah, SR ; Tian, Z ; Dell’Oglio, Paolo ; Graefen, M ; Moschini, M ; Necchi, A ; Shariat, SF ; Briganti, A ; Montorsi, F ; Karakiewicz, PI. / Contemporary rates of adherence to international guidelines for pelvic lymph node dissection in radical cystectomy: a population-based study. In: World Journal of Urology. 2018 ; Vol. 36, No. 9. pp. 1417-1422.
@article{3503d5fdd2ae4489959105323c8edbc5,
title = "Contemporary rates of adherence to international guidelines for pelvic lymph node dissection in radical cystectomy: a population-based study",
abstract = "Objective: To examine the rates of adherence to guidelines for pelvic lymph node dissection (PLND) in patients treated with radical cystectomy (RC) and to identify predictors of omitting PLND. Materials and methods: We relied on 66,208 patients treated with RC between 2004 and 2013 within the National Inpatients Sample (NIS) database. We examined the rates of PLND according to year of surgery, patient and hospital characteristics. Univariate and multivariate logistic regression analyses assessed the probability of PLND use, after adjusting for year of surgery, age, gender, race, comorbidities, hospital location, teaching status and hospital surgical volume. Results: Overall, PLND was performed on 54,223 (81.9{\%}) RC patients. The rates PLND at RC significantly increased over the study period from 72.3{\%} in 2004 to 85.9{\%} in 2013, (p < 0.001). Barriers to PLND at RC consisted of female gender (OR: 1.31; 95{\%} CI 1.25–1.38; p < 0.001), African American race (OR: 1.21; 95{\%} CI 1.10–1.32; p < 0.001), intermediate (OR: 1.78; 95{\%} CI 1.68–1.88; p < 0.001) or low surgical volume institutions (OR: 2.59; 95{\%} CI 2.44–2.74; p < 0.001), non-teaching institution status (OR: 1.21; 95{\%} CI 1.15–1.27; p < 0.001) and rural hospital location (OR: 1.13; 95{\%} CI 1.01–1.25; p = 0.03). Conclusions: It is encouraging to note increasing rates of PLND at RC over time. Both patients and hospital characteristics influence PLND rates. More efforts should be aimed at reducing inequalities in PLND at RC due to these highly modifiable variables. {\circledC} 2018 Springer-Verlag GmbH Germany, part of Springer Nature",
author = "E Zaffuto and Marco Bandini and S Gazdovich and AS Valiquette and SR Leyh-Bannurah and Z Tian and Paolo Dell’Oglio and M Graefen and M Moschini and A Necchi and SF Shariat and A Briganti and F Montorsi and PI Karakiewicz",
year = "2018",
doi = "10.1007/s00345-018-2306-7",
language = "English",
volume = "36",
pages = "1417--1422",
journal = "World Journal of Urology",
issn = "0724-4983",
publisher = "Springer Verlag",
number = "9",

}

TY - JOUR

T1 - Contemporary rates of adherence to international guidelines for pelvic lymph node dissection in radical cystectomy: a population-based study

AU - Zaffuto, E

AU - Bandini, Marco

AU - Gazdovich, S

AU - Valiquette, AS

AU - Leyh-Bannurah, SR

AU - Tian, Z

AU - Dell’Oglio, Paolo

AU - Graefen, M

AU - Moschini, M

AU - Necchi, A

AU - Shariat, SF

AU - Briganti, A

AU - Montorsi, F

AU - Karakiewicz, PI

PY - 2018

Y1 - 2018

N2 - Objective: To examine the rates of adherence to guidelines for pelvic lymph node dissection (PLND) in patients treated with radical cystectomy (RC) and to identify predictors of omitting PLND. Materials and methods: We relied on 66,208 patients treated with RC between 2004 and 2013 within the National Inpatients Sample (NIS) database. We examined the rates of PLND according to year of surgery, patient and hospital characteristics. Univariate and multivariate logistic regression analyses assessed the probability of PLND use, after adjusting for year of surgery, age, gender, race, comorbidities, hospital location, teaching status and hospital surgical volume. Results: Overall, PLND was performed on 54,223 (81.9%) RC patients. The rates PLND at RC significantly increased over the study period from 72.3% in 2004 to 85.9% in 2013, (p < 0.001). Barriers to PLND at RC consisted of female gender (OR: 1.31; 95% CI 1.25–1.38; p < 0.001), African American race (OR: 1.21; 95% CI 1.10–1.32; p < 0.001), intermediate (OR: 1.78; 95% CI 1.68–1.88; p < 0.001) or low surgical volume institutions (OR: 2.59; 95% CI 2.44–2.74; p < 0.001), non-teaching institution status (OR: 1.21; 95% CI 1.15–1.27; p < 0.001) and rural hospital location (OR: 1.13; 95% CI 1.01–1.25; p = 0.03). Conclusions: It is encouraging to note increasing rates of PLND at RC over time. Both patients and hospital characteristics influence PLND rates. More efforts should be aimed at reducing inequalities in PLND at RC due to these highly modifiable variables. © 2018 Springer-Verlag GmbH Germany, part of Springer Nature

AB - Objective: To examine the rates of adherence to guidelines for pelvic lymph node dissection (PLND) in patients treated with radical cystectomy (RC) and to identify predictors of omitting PLND. Materials and methods: We relied on 66,208 patients treated with RC between 2004 and 2013 within the National Inpatients Sample (NIS) database. We examined the rates of PLND according to year of surgery, patient and hospital characteristics. Univariate and multivariate logistic regression analyses assessed the probability of PLND use, after adjusting for year of surgery, age, gender, race, comorbidities, hospital location, teaching status and hospital surgical volume. Results: Overall, PLND was performed on 54,223 (81.9%) RC patients. The rates PLND at RC significantly increased over the study period from 72.3% in 2004 to 85.9% in 2013, (p < 0.001). Barriers to PLND at RC consisted of female gender (OR: 1.31; 95% CI 1.25–1.38; p < 0.001), African American race (OR: 1.21; 95% CI 1.10–1.32; p < 0.001), intermediate (OR: 1.78; 95% CI 1.68–1.88; p < 0.001) or low surgical volume institutions (OR: 2.59; 95% CI 2.44–2.74; p < 0.001), non-teaching institution status (OR: 1.21; 95% CI 1.15–1.27; p < 0.001) and rural hospital location (OR: 1.13; 95% CI 1.01–1.25; p = 0.03). Conclusions: It is encouraging to note increasing rates of PLND at RC over time. Both patients and hospital characteristics influence PLND rates. More efforts should be aimed at reducing inequalities in PLND at RC due to these highly modifiable variables. © 2018 Springer-Verlag GmbH Germany, part of Springer Nature

U2 - 10.1007/s00345-018-2306-7

DO - 10.1007/s00345-018-2306-7

M3 - Article

VL - 36

SP - 1417

EP - 1422

JO - World Journal of Urology

JF - World Journal of Urology

SN - 0724-4983

IS - 9

ER -