Advanced Age Is Associated with Poorer Bladder Cancer-Specific Survival in Patients Treated with Radical Cystectomy

Nielsen, Matthew E.; Shariat, Shahrokh F.; Karakiewicz, Pierre I.; Lotan, Yair; Rogers, Craig G.; Amiel, Gilad E.; Bastian, Patrick J.; Vazina, Amnon; Gupta, Amit; Lerner, Seth P.; Sagalowsky, Arthur I.; Schoenberg, Mark; Palapattu, Ganesh S.

doi:10.1016/j.eururo.2006.11.004

Cited by 159 publications

(113 citation statements)

References 19 publications

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“…It is reported that the tumor is more differentiated and less aggressive in bladder tumor patients younger than 40 years of age (28,29). In addition, other studies reported decreased recurrence and progression rates in younger patients as well (28,29,30,31,32). As opposed to this, there are also other studies that showed no significant difference between age (33,34,35).…”

Section: Discussioncontrasting

confidence: 39%

The Effect of Sex and Age Differences on Pathology Results in Primary Bladder Cancer Patients

Türk¹,

Ün²,

Ergani³

2017

uob

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Objective: Bladder cancer is more frequently seen in males, whereas prognosis is usually worse in female patients. Although many factors affect the prognosis of urothelial carcinoma of bladder have been proposed, the effect of female gender on the prognosis of bladder urothelial carcinoma is controversial. Several factors have been suggested regarding the effect of gender difference on the prognosis of bladder urothelial carcinoma. Materials and Methods: A retrospective study of 589 patients who underwent transurethral resection for the first time between January 2011 and January 2017 with preliminary diagnosis of bladder cancer was performed. Age, sex, tumor stage, histological subtype and tumor grade were evaluated in the study. Results: No significant difference was found between the sexes in terms of tumor stage (p=0.663). The rate of high-grade tumors was 48.6% (n=235) in males and 63% (n=41) in females and statistically significantly higher in females than males (p<0.041). As the age progressed, it was found that tumor stage and extend increased (p<0.0001). Tumor grade and histological subtype were not statistically significant in terms of age groups. Conclusion:In this study, newly diagnosed bladder tumor patients evaluated and revealed more in male gender. Furthermore, when evaluated in terms of age groups, it was shown that the stage and degree of the tumor increased as the age increased.

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Section: Discussioncontrasting

confidence: 39%

The Effect of Sex and Age Differences on Pathology Results in Primary Bladder Cancer Patients

Türk¹,

Ün²,

Ergani³

2017

uob

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“…Clark et al [20] found that 5-year overall survival declined with increasing age for bladder cancer patients. Nielsen et al [21] found that advanced age was independently associated with poorer disease specific survival in cystectomy patients. The relationship between race and survival is striking, particularly in cystectomy patients (Tables 1 and 3).…”

Section: Discussionmentioning

confidence: 99%

Prognostic Impact of Comorbidity in Patients with Bladder Cancer

Megwalu¹,

Vlahiotis²,

Radwan³

et al. 2008

European Urology

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Objective-To determine the impact of comorbidity on survival of bladder cancer patients.Methods-The population included 675 patients with newly diagnosed bladder cancer whose medical information was abstracted from a hospital cancer registry. Adult Comorbidity Evaluation-27, a validated instrument, was used to prospectively categorize comorbidity. Independent variables assessed include comorbidity, American Joint Committee on Cancer (AJCC) stage, grade, age, gender, and race. Outcome measure was overall survival. We analyzed the entire cohort, patients with noninvasive disease, and patients requiring cystectomy. Cox proportional hazards analysis was used to assess impact of independent variables on survival.Results-Median age at diagnosis for the entire cohort was 71 yr and median follow-up was 45 mo. Of 675 patients, 446 had at least one comorbid condition and 301 died during follow-up. On multivariable analysis for the entire cohort, comorbidity (p = 0.0001), AJCC stage (p = 0.0001), age (p = 0.0001), and race (p = 0.0045) significantly predicted overall survival. On subset analysis of noninvasive bladder cancer patients, comorbidity (p = 0.0001) and age (p = 0.0001) independently predicted overall survival, whereas stage, grade, race, and gender did not. On subset analysis of cystectomy patients, comorbidity (p = 0.0053), stage (p = 0.0001), and race (p = 0.0449) significantly predicted overall survival.Conclusions-Comorbidity is an independent predictor of overall survival in the entire cohort of bladder cancer patients, the subset with noninvasive disease, and the subset treated with cystectomy.

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“…It has been demonstrated that an individual patient's risk for bladder cancer depends on several factors, including age, tobacco use and chemical exposures (Nielsen et al, 2007). However, few models have been developed to quantify individual risk of having bladder cancer after presenting with hematuria (Nielsen et Davis et al, 2012).…”

Section: Introductionmentioning

confidence: 99%

External Validation of a Clinical Scoring System for Hematuria

Lee

Kim

et al. 2014

Asian Pacific Journal of Cancer Prevention

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Background: The aim of this study was to evaluate the accuracy of a new scoring system in Korean patients with hematuria at high risk of bladder cancer. Materials and Methods: A total of 319 consecutive patients presenting with painless hematuria without a history of bladder cancer were analyzed, from the period of August 2012 to February 2014. All patients underwent clinical examination, and 22 patients with incomplete data were excluded from the final validation data set. The scoring system included four clinical parameters: age (≥50 = 2 vs. <50 =1), gender (male = 2 vs. female = 1), history of smoking (smoker/ex-smoker = 4 vs. non-smoker = 2) and nature of the hematuria (gross = 6 vs. microscopic = 2). Results: The area under the receiver-operating characteristic curve (95% confidence interval) of the scoring system was 0.718 (0.655-0.777). The calibration plot demonstrated a slight underestimation of bladder cancer probability, but the model had reasonable calibration. Decision curve analysis revealed that the use of model was associated with net benefit gains over the treat-all strategy. The scoring system performed well across a wide range of threshold probabilities (15%-45%). Conclusions: The scoring system developed is a highly accurate predictive tool for patients with hematuria. Although further improvements are needed, utilization of this system may assist primary care physicians and other healthcare practitioners in determining a patient's risk of bladder cancer.

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Advanced Age Is Associated with Poorer Bladder Cancer-Specific Survival in Patients Treated with Radical Cystectomy

Cited by 159 publications

References 19 publications

The Effect of Sex and Age Differences on Pathology Results in Primary Bladder Cancer Patients

The Effect of Sex and Age Differences on Pathology Results in Primary Bladder Cancer Patients

Prognostic Impact of Comorbidity in Patients with Bladder Cancer

External Validation of a Clinical Scoring System for Hematuria

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