The clinical and economic burden of perioperative complications of radical cystectomy

Radical cystectomy (RC) is the gold standard treatment and most effective method for local control of muscle invasive and high risk, non-invasive bladder cancer (1,2). RC is, unfortunately, a major surgery with significant attendant morbidity. Notwithstanding improvements in surgical technique and pre-, peri-, and postoperative care, 27–64% of patients experience at least one complication with a 26–43% 90-day readmission rate and a 1.5–3% 30-day mortality rate (3-6). These numbers also bespeak the relative frailty and poor baseline physiologic reserve of patients frequently in consideration for RC. Thus, the decision to proceed with surgery should involve a careful and thoughtful weighing of risks to benefits as well as a thorough discussion with the patient on their individualized risks.