[Treatment of bladder cancer in the elderly]

In Germany, bladder cancer is the fourth most common malignancy in males, while it occupies the 14th place in females. About 75% of cases occur in patients aged 65 or more years.

Elderly patients with nonmuscle-invasive bladder cancer appear to harbor a higher risk of disease recurrence and progression and should undergo the same treatment and careful surveillance as their younger counterparts. Elderly patients with muscle-invasive bladder cancer undergoing radical cystectomy are at an increased risk of perioperative morbidity and mortality and should be referred to experienced high-volume centers.

Beside radical cystectomy as standard treatment, several bladder-sparing approaches (transurethral resection, chemotherapy, radiotherapy, chemoradiotherapy) are available which may be treatment alternatives in carefully selected cases. Valid randomized comparisons between these approaches and radical cystectomy are, however, still lacking.