Cystectomy in the elderly

Invasive bladder cancer is a disease of the elderly. With the elderly population rapidly growing and living longer than ever before, a larger number of patients 75 years of age or older will develop invasive bladder cancer. Currently available data indicate that well-selected elderly patients, even those 80 years old or older, do not have a significantly higher risk of morbidity or mortality from cystectomy than do younger patients. Cystectomy in patients of advanced age requires a multidisciplinary team approach and increased vigilance in the perioperative period but can be performed safely. Most elderly patients diagnosed with invasive bladder cancer, if left untreated by cystectomy, will die of the disease and not from competing age-related illness. Therefore, radical cystectomy should not be withheld from elderly patients on the basis of age alone.