Outcomes of Selective Bladder Preservation in the Elderly Treated With Conservative Surgery and Chemoradiation

Clayman, R.H.; Shipley, William U.; Galland-Girodet, S.; Niemierko, Andrzej; Gray, Phillip J.; Paly, Jonathan J.; Heney, Niall M.; Kaufman, Donald S.; Zietman, Anthony L.; Efstathiou, Jason A.

doi:10.1016/j.ijrobp.2013.06.216

Cited by 11 publications

(9 citation statements)

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“…A prospective trial on elderly patients (≥75 years) treated with selective bladder preservation showed 33% of patients achieved complete response and 60% carrying on to a full course of combined modality therapy. Five- (60%) and 10-year DSS rates (56%) were similar to that of patients undergoing RadC [ 76 ]. Radiation alone can be used to palliate local disease-associated symptoms such as hematuria, dysuria or frequency [ 29 77 ].…”

Section: Other Treatments For Elderly Bladder Cancer Patientsmentioning

confidence: 90%

Treatment of bladder cancer in the elderly

Erlich

Zlotta

2016

Investig Clin Urol

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As the population ages and life expectancy increases in the human population, more individuals will be diagnosed with bladder cancer (BC). The definition of who is elderly is likely to change in the future from the commonly used cut-off of ≥75 years of age. Physiological rather than chronological age is key. BC care in the elderly is likely to become a very common problem in daily practice. Concerns have been raised that senior BC patients are not given treatments that could cure their disease. Clinicians lack quantitative and reliable estimates of competing mortality risks when considering treatments for BC. Majority of patients diagnosed with BC are elderly, making treatment decisions complex with their increasing number of comorbidities. A multidisciplinary approach to these patients may be a way to incorporate discussion from various disciplines regarding treatment options available. Here we review various treatment options for elderly patients with muscle invasive BC and nonmuscle invasive BC. We include differences in treatments from robotic versus open radical cystectomy, various urinary diversion techniques, chemotherapy, radiation therapy and combination treatments. In clinical practice, treatment decisions for elderly patients should be done on a case-by-case basis, tailored to each patient with their specific histories and comorbidities considered. Some healthy elderly patients may be better candidates for extensive curative treatments than their younger counterparts. This implies that these important, life-altering decisions cannot be solely based on age as many other factors can affect patient survival outcomes.

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Section: Other Treatments For Elderly Bladder Cancer Patientsmentioning

confidence: 90%

Treatment of bladder cancer in the elderly

Erlich

Zlotta

2016

Investig Clin Urol

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“…Turgeon and Souhami 20 conducted a review of the use of TMT for MIBC in elderly patients, in which they presented a table of outcomes and toxicity data from 8 publications and 4 conference abstracts, summing to a total of 496 elderly patients. [21][22][23][24][25][26][27][28][29][30][31][32] Although the definition of "elderly" is variable in the literature, Turgeon and Souhami reported the most common definition of elderly to be those aged 70 years, which was used in greater than one-half of the studies reviewed. The median reported age of patients in the reviewed studies was 78 years.…”

Section: Discussionmentioning

confidence: 99%

Concurrent chemotherapy is associated with improved survival in elderly patients with bladder cancer undergoing radiotherapy

Korpics

Block

Martin

et al. 2017

Cancer

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“…Thus, this is still a treatment for healthier patients. Definitive therapy, whether surgery or radiation therapy, is underutilized in older patients as only half of patients over the age of 70 undergo curative intent therapy [1, 25]. Yet data suggest an appropriately selected population derives similar benefit to younger patients undergoing chemotherapy and radiation [26–30].…”

Section: Current Treatment For Muscle Invasive and Metastatic Diseasementioning

confidence: 99%

Treatment of Urothelial Cancer in Elderly Patients: Focus on Immune Checkpoint Inhibitors

2018

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Urothelial carcinoma, or bladder cancer, is a malignancy that most commonly affects older patients. The median age at diagnosis is 73 years, and care of these patients requires consideration not just of the disease-related factors such as stage and histology, but also of patient-related factors. Many of these patients have concurrent medical morbidities and additional changes related to the aging process. Older patients with cancer are a unique population requiring additional considerations and assessment in treatment decision-making. It is important to look beyond chronologic age. The traditional treatment for advanced disease has relied on platinum-based chemotherapy. These multi-agent regimens require consideration of baseline organ function as well as competing conditions that may heighten toxicity. The advent of a new class of cancer therapeutics, the immune checkpoint inhibitors, has changed the care of patients with advanced disease considerably. These immunotherapeutics have been approved for treating patients with disease progression on chemotherapy, or those who are ineligible (or unfit) to receive cisplatin-based therapy. This expansion of the population of patients eligible for treatment has great applicability to the unique considerations in an older patient population. In general, these new immunotherapies are well tolerated and effective in this group of patients.

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Outcomes of Selective Bladder Preservation in the Elderly Treated With Conservative Surgery and Chemoradiation

Cited by 11 publications

References 0 publications

Treatment of bladder cancer in the elderly

Treatment of bladder cancer in the elderly

Concurrent chemotherapy is associated with improved survival in elderly patients with bladder cancer undergoing radiotherapy

Treatment of Urothelial Cancer in Elderly Patients: Focus on Immune Checkpoint Inhibitors

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