Tufts University School of Medicine, Boston, MA
Ilana Goldberg , Steven Lee Chang , Shilajit Kundu , Benjamin I. Chung , Eric A. Singer
Background: Recent studies suggest an association between prostate cancer and inflammatory bowel disease (IBD). Our objectives were to investigate clinical and financial impacts of IBD on radical prostatectomy (RP), and to determine the impact of surgical approach on our findings. Methods: The Premier Hospital Database was queried for patients who underwent RP from 2003 to 2017. Multivariable logistic regression models were used to determine the independent impact of IBD on complications and readmission rates. We determined 90-day readmissions and examined 90-day hospital costs adjusted to 2019 US dollars with multivariable quantile regression models. Results: Our study population included 262,189 men with prostate cancer, including 3,408 (1.3%) with IBD. There were higher odds for any complication for IBD patients compared to non-IBD controls for RP (15.64% vs. 10.66%). IBD patients had overall complication rates of 14.1% (P< 0.05) for open surgery and 17.2% for MIS (P< 0.01). Between 2013-2017, the IBD cohort had significantly more complications (OR: 2; 95% CI: 1.5 to 2.67; P < 0.0001), was more likely to have surgical costs in the top quartile (OR: 1.6; 95% CI: 1.23 to 2.1; P< 0.01), and had higher readmission rates (OR: 1.51; 95% CI: 1.1 to 2.06; P = 0.01). Conclusions: The IBD cohort who underwent MIS had the highest complication rates. Hospital readmissions and surgical costs were significantly higher for the IBD cohort who underwent RP between 2013-2017, when a minimally invasive approach was more prevalent than an open approach. These findings may be important when deciding which surgical approach to take when performing RP on men with IBD.
2003 - 2007 n = 61,119 | 2008 - 2012 n = 110,255 | 2013 - 2017 n = 90,816 | ||||
---|---|---|---|---|---|---|
IBD vs no IBD aOR (95% CI) | p | IBD vs no IBD aOR (95% CI) | p | IBD vs no IBD aOR (95% CI) | p | |
Overall Complications | 1.02 (0.38 to 2.74) | 0.97 | 1.41 (0.97 to 2.05) | 0.07 | 2 (1.5 to 2.67) | <0.0001 |
Minor Complications | 0.86 (0.29 to 2.57) | 0.79 | 1.43 (0.95 to 2.14) | 0.08 | 1.73 (1.24 to 2.41) | 0.001 |
Major Complications | 2.4 (0.31 to 18.61) | 0.4 | 1.15 (0.43 to 3.06) | 0.78 | 2.56 (1.63 to 4.03) | <0.0001 |
High Cost Surgery | ||||||
Top quartile | 1.38 (0.77 to 2.47) | 0.27 | 1.19 (0.88 to 1.6) | 0.26 | 1.6 (1.23 to 2.1) | 0.001 |
Readmissions | 1.29 (0.5 to 3.33) | 0.6 | 1.08 (0.49 to 2.38) | 0.85 | 1.51 (1.1 to 2.06) | 0.01 |
Disclaimer
This material on this page is ©2024 American Society of Clinical Oncology, all rights reserved. Licensing available upon request. For more information, please contact licensing@asco.org
Abstract Disclosures
2023 ASCO Annual Meeting
First Author: Nasreen Khan
2024 ASCO Annual Meeting
First Author: Shingo Hatakeyama
2023 ASCO Annual Meeting
First Author: Tian Zhang
2024 ASCO Genitourinary Cancers Symposium
First Author: Thilo Westhofen