Abstract
Objective
To examine relationships between neighborhood socioeconomic disadvantage and outcomes
following radical cystectomy (RC).
Materials and Methods
A retrospective single institution study of consecutive RCs performed for bladder
cancer between 2011 and 2019. Major complications, mortality and survival outcomes
were compared using Cochran-Armitage or Kruskal-Wallis tests. Cox proportional hazards
models were used for time-to-event analyses.
Results
A total of 906 patients were included in analysis. Overall 90-day mortality was 2.98%
(27/906). Ninety-day mortality rates observed in the least (first) and most (fourth)
disadvantaged ADI quartiles were 0% (0/115) and 6.5% (12/185), respectively. Patients
from the fourth quartile demonstrated worse overall survival and recurrence free survival
than those in the first quartile. ADI quartile was positively associated with muscle
invasive (P = .0006) and node positive (P = .042) disease. ADI percentile was an independent predictor for 90-day mortality
(adjusted OR: 1.022, CI: 1.004-1.04, P = .015).
Conclusion
Higher rates of mortality and worse oncologic outcomes were observed for patients
residing in the most disadvantaged quartile. ADI was associated with higher likelihood
of 90-day mortality and may therefore be useful in patient counseling, risk stratification,
and post-discharge management.
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Article info
Publication history
Published online: December 29, 2021
Accepted:
October 28,
2021
Received:
July 17,
2021
Footnotes
Funding Support: Funded by the Case Comprehensive Cancer Center.
Identification
Copyright
© 2021 Elsevier Inc. All rights reserved.
