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Radical cystectomy in the octogenarian
N Stroumbakis1, H W Herr, M S Cookson
1Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, New York, USA.
The Journal of Urology
|November 20, 1997
Summary
Cystectomy and urinary diversion in patients 80 years or older with invasive bladder cancer showed acceptable morbidity and mortality. Radical cystectomy offers octogenarians a good chance for disease-free survival.
Area of Science:
- Urology
- Oncology
- Geriatric Medicine
Background:
- Invasive bladder cancer presents unique challenges in elderly patients.
- Treatment decisions for octogenarians require careful consideration of risks and benefits.
Purpose of the Study:
- To evaluate the morbidity and outcomes of cystectomy and urinary diversion in patients aged 80 and older with invasive bladder cancer.
- To assess the safety and efficacy of radical cystectomy in an octogenarian population.
Main Methods:
- Retrospective review of 44 patients aged 80+ who underwent cystectomy over 15 years.
- Evaluation of post-surgical complications, mortality, functional status, and survival.
- Analysis of patient co-morbidities and healthcare utilization, including intensive care and rehospitalization.
Main Results:
- The study included 44 patients with a median age of 81, 78% having significant co-morbidities.
- A 51% complication rate was observed, with 4.5% operative mortality and 66% rehospitalization within 6 months.
- Median survival was 25 months, with a slight decrease in performance status post-surgery.
Conclusions:
- Cystectomy is a viable option for octogenarians with invasive bladder cancer.
- Radical cystectomy can be performed with acceptable morbidity and mortality in this age group.
- This surgery provides the best opportunity for sustained, disease-free quality survival for elderly patients.