Association between perioperative morbidity and mortality after radical cystectomy: an opportunity to understand the complication snowball effect

Radical cystectomy (RC) is currently the standard treatment for muscle invasive bladder cancer (1). Perioperative complications after RC have been reported in upwards of 60% of patients (2,3). Perioperative mortality is similarly concerning, with overall rates estimated between 1–3% (3,4). As patients age, the 90-day perioperative mortality rate has been shown to increase to 5%, 7%, and 11% in patients 65, 75, and 80 years or greater, respectively (5). While many studies have assessed the incidence of and predictors for complications and mortality for RC, there is a paucity of reports that examine the direct association between complications and mortality (6,7). Therefore, this topic is of importance for further investigation.