What’s new in bladder cancer research?

A randomized, single-centre, single-blinded trial was conducted in 157 consecutive patients who underwent extended pelvic lymph node dissection, radical cystectomy, and ileal urinary diversion.1 The goal of the study was to determine the long-term oncological and functional outcomes of postoperative total parenteral nutrition (TPN) in this population. Patients were randomly assigned to receive either postoperative TPN within 24 hours of their operation (n=74) or oral nutrition alone (n=83). Patients receiving oral nutrition alone had more favourable long-term bowel function at three and 12 months compared with those who received TPN. There was no difference in oncological outcomes between the two groups, including overall survival (OS), cancer-specific survival, recurrence-free survival, and local recurrence-free survival. However, malnutrition was associated with poor postoperative outcomes in both groups and postoperative TPN did not demonstrate any benefit over oral alimentation alone in the malnourished group of patients. Therefore, while administration of TPN does not appear to impair long-term oncological outcomes after extended pelvic lymph node dissection, radical cystectomy, and urinary diversion, postoperative TPN appears to negatively influence long-term bowel function. Its use should, therefore, be limited to a highly selected cohort of patients