SUMMARY
The immediate (intra- and early postoperative complications) and long-term results (overall, adjusted and relapse-free survival rates) and quality of life of patients were studied in a series of 257 consecutive radical cystectomies with various types of urine diversion for muscle-invasive bladder cancer at the clinic of the National Oncology Center of the Ministry of Health of the Republic of Azerbaijan in the period from 2008 to 2017. Factors that have a significant impact on the frequency and nature of complications and survival rates were also identified. Intraoperative mortality was 0.4%, the complication rate was 13.2%. In the early postoperative period, 191 complications of varying severity were recorded in 111 (43.2%) patients. In the multivariate analysis, independent predictors of any postoperative complications after RC were local cT4 tumor extent (OR 4.52; p=0.002), age (OR 1.87; p=0.017), positive urine culture (OR 2.16; p=0.032), and the number of RCs performed by the surgeon (OR 0.89; p=0.038). The 5-year survival to the first clinical event, which was understood as the development of local recurrence or distant metastases, was 63.1% (SE 3.2%), the median RFS was not reached. The 5-year SFS was 65.3% (SE 3.2%), the median was also not reached. The 5-year OS was 54.1% (SE 3.2%), the median OS was 65.7 months. In our study, independent factors statistically significantly associated with the risk of developing complications after RC were local prevalence of cT4 tumor, age, positive urine culture before the intervention, and a small number of surgeries performed by the surgeon or positive urine culture and age, respectively. In addition to demographic indicators (gender and age) and tumor process indicators, survival rates are significantly affected by factors such as ICC (p<0.01) and the experience of the surgical team (p<0.01).
Keywords: Bladder cancer, radical cystectomy, complications, survival

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REFERENCES

1. Jubber I, Ong S, Bukavina L, Black PC, et al. Epidemiology of Bladder Cancer in 2023: A Systematic Review of Risk Factors // Eur Urol. 2023 Aug;84(2):176-190. doi: 10.1016/j.eururo.2023.03.029
2. Алиев Д.А., Марданлы Ф.А., Мусаев Т.Н. Динамика статистических показателей рака мочевого пузыря в Азербайджане // Azərbaycan onkologiya jurnalı. 2016, №2, с. 9-12.
3. Алиев К.А., Бондарев А.В. Оптимальный вариант деривации мочи при раке мочевого пузыря у лиц пожилого и старческого возраста // Журнал онкология имени Герцена., №1, 2014, с. 85-89.
4. Alfred Witjes J, Lebret T, Compérat EM, Cowan NC, et al. Updated 2016 EAU Guidelines on Muscle-invasive and Metastatic Bladder Cancer // Eur Urol. 2017 Mar;71(3):462-475. doi: 10.1016/j.eururo.2016.06.020
5. Dindo D, Demartines N, Clavien PA. Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey // Ann Surg. 2004 Aug;240(2):205-13. doi: 10.1097/01.sla.0000133083.54934.ae
6. Clavien PA, Barkun J, de Oliveira ML, Vauthey JN, et al. The Clavien-Dindo classification of surgical complications: five-year experience // Ann Surg. 2009 Aug;250(2):187-96. doi: 10.1097/SLA.0b013e3181b13ca2
7. Ланг Т.А., Сесик М. Как описывать статистику в медицине. Аннотированное руководство для авторов, редакторов и рецензентов (пер. с англ. ; под ред. В. П. Леонова) – Москва: Практическая медицина, 2011. – 480 с.
8. EORTC QLQ-C30 Scoring Manual (3rd edition). Fayers PM, Aaronson NK, Bjordal K, Groenvold M, Curran D, Bottomley A, on behalf of the EORTC Quality of Life Group. Brussels: European Organisation for Research and Treatment of Cancer, 2001. ISBN: 2-9300 64-22-6.
9. EORTC Quality of Life. Muscle Invasive Bladder Cancer. Questionnaire. Available at: https://qol.eortc.org/questionnaire/qlq-blm30/