Introduction:

Managing muscle invasive bladder cancer (MIBC) is challenging due to complex treatments and high readmission rates post-intervention. Historically, treatment modalities for MIBC such as chemotherapy, radiation, and surgery, are associated with considerable side-effect profiles that can adversely impact patient outcomes. The adoption of trimodal therapy (TMT) has been recognized as a viable alternative to cystectomy for selected patients, with existing literature focusing on the long-term outcomes and associated morbidities of this approach. 

Despite this, there remains a paucity of information regarding the short-term complications of TMT, particularly those leading to early readmission. This study evaluates the early post-treatment complications that necessitate hospital readmission within 90 days following the initiation of TMT. 

Methods:

We performed a retrospective analysis through chart review of patients receiving TMT with curative intent over the time period of September 2019 through September 2023.  Short-term readmission was defined as readmission to the hospital within the first 90 days following initiation of chemoradiation portion of the TMT. 

Results:

A total of 70 patients received TMT over the four-year period. Patient demographics are detailed in table 1. The total number of readmissions to the hospital was 13 (18.6%). The average length of stay was 2.91 days. The most common cause for readmission was febrile UTI (11.4%, n=8). Other causes for readmission were acute kidney injury (4.28%, n=3) and acute lower urinary tract symptoms (2.86%, n=2). Only 1 received operative intervention which was for indwelling stent replacement. There were no deaths within the acute 90-day window. 

Conclusion:

Our findings reveal 18.6% of patients experienced readmission within the initial 90-day period following trimodal therapy for muscle invasive bladder cancer. Despite this notable readmission rate, the associated morbidity among these patients remained low. These outcomes underscore the potential of trimodal therapy as a treatment with a favorable short-term safety profile.  

Funding: N/a