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Laparoscopic Radical Cystectomy in the Elderly - Results of a Single Center LRC only Series
Tom J N Hermans1, Laurent M C L Fossion1, Rob Verhoeven2
1Department of Urology, Maxima Medical Center Veldhoven, Veldhoven, The Netherlands.
Objective:
To compare outcome of laparoscopic radical cystectomy (LRC) with ileal conduit in 22 elderly (≥75 years.) versus 51 younger (< 75 years.) patients.
Materials And Methods:
Analysis of prospectively gathered data of a single institution LRC only series was performed. Selection bias for LRC versus non-surgical treatments was assessed with data retrieved from the Netherlands Cancer Registry.
Results:
Median age difference between LRC groups was 9.0 years (77.0 versus 68.0 years). Both groups had similar surgical indications, body mass index and gender distribution. Charlson Comorbidity Index score was 3 versus 4 in ≥50% of younger and elderly patients. Median operative time (340 versus 341 min) and estimated blood loss (< 500 versus >500mL) did not differ between groups. Median total hospital stay was 12.0 versus 14.0 days for younger and elderly patients. Grade I-II 90-d complication rate was higher for elderly patients (68 versus 43%, p=0.05). Grade III-V 90-d complication rate was equal for both groups (23 versus 29%, p=0.557). 90-d mortality rate was higher for elderly patients (14 versus 4%, p=0.157). Median follow-up was 40.0 months for younger and 57.0 months for elderly patients. Estimated overall and cancer-specific survival at 5years. was 46% versus 35% and 64% versus 64% for youn¬ger and elderly patients respectively.
Conclusions:
Our results suggest that LRC is feasible in elderly patients, where a non¬-surgical treatment is usually favoured.