Comparison of standard vs. palliative management for bladder cancer in patients older than 85 years: multicenter study of 317 de novo tumors

Carrión, Albert; Huguet, J.; Ribal, María J.; Domínguez, A.; Bonet, Xavier; Servián, Pol; Mayordomo, Olga; Ajami, Tarek; Picola, Natàlia; Freixa, Roger; Díaz, Fernando Jiménez; Lozano, F.; Raventós, Carles X.; Moróte, Juan

doi:10.1016/j.urolonc.2019.09.007

Cited by 6 publications

(4 citation statements)

References 15 publications

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“…A recent study suggested that more conservative strategies should be considered in MIBC because of the low survival rate of very old patients regardless of the treatment. However, the number of patients in this study was too small to draw a definite conclusion, and cystectomy was rarely used at the 6 institutions of the study ( 13 ). Whether it is reasonable to undertreat elderly patients is uncertain based on the available literature ( 17 ).…”

Section: Discussionmentioning

confidence: 94%

“…In addition, the SEER database does not provide information about additional confounding factors, such as renal function (22), ASA score, and Charlson comorbidity score. However, they failed to predict OS in patients over 85 years of age in a recent study (13). The lack of this information prevented us from evaluating whether patients in the three groups had similar health conditions.…”

Section: Discussionmentioning

confidence: 96%

“…A recent multicenter study recommended that patients over 85 years should receive the same tumor management as younger patients considering the extended survival of NMIBC patients ( 13 ). However, the sample size was relatively small (156 HG NMIBC patients).…”

Section: Discussionmentioning

confidence: 99%

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Treatment decisions of bladder cancer in patients older than 85 years: a SEER-based analysis 2011–2015

Zhu¹,

Ye²,

Zhou³

et al. 2022

Transl Cancer Res TCR

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Background: To compare the survival outcomes of patients over 85 years of age with bladder cancer.Methods: We used data collected from the Surveillance, Epidemiology, and End Results (SEER) database.Kaplan-Meier (KM) curves were generated for overall survival with 95% confidence intervals (CIs). Cox proportional hazard models were used to estimate the hazard ratios among cases in different groups.Results: Of the 9,321 patients who met the inclusion criteria, 6,703 (71.9%) were men and 2,618 (28.1%) were women, with a mean (standard deviation) age of 88.68 (3.216) years. The median follow-up time of this cohort was 18 months. In the low-grade non-muscle-invasive bladder cancer (LG NMIBC) group, our analysis showed that no further treatment led to a better prognosis after the first transurethral bladder tumor resection (TURBT). In the high-grade NMIBC (HG NMIBC) cohort, major therapy was correlated with better OS in univariable and multivariable analyses [hazard ratio (HR) 0.450; 95% CI: 0.351-0.577]. Trimodal therapy gave a better prognosis in the muscle-invasive bladder cancer (MIBC) cohort (HR 1.395; 95% CI: 1.147-1.697). In addition, none of the county factors were risk factors for prognosis in multivariable analysis.Conclusions: Minor and major therapies do not have a better prognosis after TURBT in LG NMIBC.Major therapy has better oncological outcomes in LG NMIBC and MIBC than minor therapy. Trimodal therapy leads to longer OS in MIBC. In addition, none of the county factors were risk factors for prognosis.

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Section: Discussionmentioning

confidence: 94%

Section: Discussionmentioning

confidence: 96%

See 1 more Smart Citation

Treatment decisions of bladder cancer in patients older than 85 years: a SEER-based analysis 2011–2015

Zhu¹,

Ye²,

Zhou³

et al. 2022

Transl Cancer Res TCR

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“…Symptomatic outcomes were not reported but no difference was found between rates of emergency department visits (33 vs. 33%). Six and 27% Clavien–Dindo grade at least 3 complications were reported for TURBT and radical cystectomy, respectively [20 ▪ ].…”

Section: Bladder Cancermentioning

confidence: 99%

The role of surgery for loco-regional and advanced urological cancers

Chow

Tay

Yuen

et al. 2022

Current Opinion in Urology

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Purpose of reviewThere is a general misconception that surgery is the antithesis of palliation. However, symptom mitigation, the basic tenet of palliative interventions, can be achieved by invasive procedures. Surgical care, thus, plays an important role in palliative oncology, alongside radiation and systemic therapy. There is global movement to improve palliation in oncology, and thus it is timely to evaluate the role of surgical interventions can play in this setting. Recent findingsMany of the surgical interventions done with palliative intent were first established as curative options. Most studies looked at interventions for local control of primary tumour including extirpative surgeries, while some studies studied pain relief for bone metastases. Results show that patients have an acceptable survival outcome and complication rate comparable to those done in the curative setting. However, not all studies report functional outcomes and symptom-relief consistently, highlighting an unmet need. SummaryMore studies are needed to further define the role of surgery in palliative care. Randomized controlled trials studying surgical intervention in the palliative setting will be challenging because of lack of equipoise, inherent bias in patient and disease characteristics in those who undergo surgery. Nonetheless, studies should endeavour to study symptom-free survival and PROMs as meaningful endpoints of interventions performed in a palliative setting rather than solely focus on hard oncological endpoints of survival.

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Optimización del tratamiento del cáncer de vejiga no músculo invasivo mediante una app

Beardo

Pinto

Astibia

et al. 2022

Actas Urológicas Españolas

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Comparison of standard vs. palliative management for bladder cancer in patients older than 85 years: multicenter study of 317 de novo tumors

Cited by 6 publications

References 15 publications

Treatment decisions of bladder cancer in patients older than 85 years: a SEER-based analysis 2011–2015

Treatment decisions of bladder cancer in patients older than 85 years: a SEER-based analysis 2011–2015

The role of surgery for loco-regional and advanced urological cancers

Optimización del tratamiento del cáncer de vejiga no músculo invasivo mediante una app

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