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Does patient age affect survival after radical cystectomy?
David Horovitz1, Polat Turker, Peter J Bostrom
1Department of Surgical Oncology, Division of Urology, University of Toronto, Princess Margaret Hospital, Toronto, Canada.
BJU International
|May 4, 2012
Summary
Radical cystectomy (RC) is a viable treatment for carefully selected elderly patients. Senior adults aged 80 years and older experience similar survival outcomes to younger patients after RC.
Area of Science:
- Urology
- Oncology
- Geriatrics
Background:
- Comorbidity is a predictor of survival in bladder cancer patients undergoing radical cystectomy (RC).
- Elderly patients often have higher stage at diagnosis and longer delays to treatment.
- Conflicting data exists regarding the outcomes of RC in elderly patients.
Purpose of the Study:
- To analyze the impact of patient age on survival after radical cystectomy (RC).
Main Methods:
- Retrospective analysis of 605 patients undergoing RC from two academic institutions (1985-2010).
- Patients were stratified into four age groups: ≤59, 60-69, 70-79, and ≥80 years.
- Comparison of demographic, clinical, pathological data, and survival rates (RFS, DSS, OAS).
Main Results:
- Elderly patients (≥80 years) had higher ASA scores and received less adjuvant treatment.
- Ileal conduit urinary diversion was exclusively used in patients ≥80 years.
- No significant differences in recurrence-free survival (RFS), disease-specific survival (DSS), or overall survival (OAS) were observed between age groups.
Conclusions:
- Radical cystectomy (RC) is a viable treatment option for carefully selected elderly patients.
- Senior patients (≥80 years) should not be denied RC if deemed fit for surgery.
- Elderly patients do not exhibit adverse histopathological features compared to younger counterparts.
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