Radical cystectomy in patients over 80 years old in Quebec: A population‐based study of outcomes

Abstract

A total of 275 patients over 80 years old had RC performed in 38 hospitals across Quebec. Among them, 33% had major post-operative complications with 16% having more than one complication. Mortality rates at 30, 60 and 90 days were 5.8%, 9.8% and 13% respectively. 44.3% of RCs were performed in seven academic hospitals with mortality rates of 2.5%, 6.5% and 9% respectively. Community hospitals had mortality of 8.5%, 12.4% and 16.3% respectively (P < 0.001). The cohort 5-year overall survival rate was 27%. The presence of post-operative complications and the number of complications negatively affected overall survival (P < 0.001) CONCLUSION: Patients over 80 years of age have high post-RC mortality rates, especially at 90 days. In addition, it appears that they have lower post-operative mortality if their RCs were performed in academic centers. Mortality rates and complications can be used when obtaining informed consent.

Short‐ and long‐term survival has improved after radical cystectomy for bladder cancer in Québec during the years 2000‐2015

“…The basis for the dichotomizing year of surgery was to compare our new cohort (2010‐2015) to the existing cohort on which we published previously (2000‐2009) . Coincidentally, when analyzing individual years, we observed a similar survival rate in patients undergoing RC between 2000 and 2008, and in patients undergoing surgery between 2010 and 2015 (data not shown).…”

“…We have previously reported the clinical outcome after RC between 2000 and 2009, using data from Québec provincial registries. 3,5,[10][11][12][13][14][15][16] In these studies, we concluded among others that overall survival was improved in patients who had an RC performed by high-volume surgeons and in high-volume hospitals. 5 In the current manuscript, Readmission rates are shown as the number of patients readmitted within 30/60/90 days after initial discharge, divided by the total number of patients (%).…”

“…We have previously reported the clinical outcome after RC between 2000 and 2009, using data from Québec provincial registries . In these studies, we concluded among others that overall survival was improved in patients who had an RC performed by high‐volume surgeons and in high‐volume hospitals .…”

“…Our previously published studies on this topic included patients up to 2009, and most other studies have not included more recent patients, while the treatment of BC patients is constantly evolving, such as the increased usage of neoadjuvant chemotherapy. Therefore, we have updated our cohort until 2016, analyzing data from virtually all patients with invasive BC treated with RC in Québec province between 2000 and 2016.…”

“…8 In contrast, a recent study conducted in the northeastern part of the United States concluded that RC were increasingly conducted in very high-volume hospitals, and that mortality had improved, while the length of hospital stays had decreased between 1996 and 2009. 9 Our previously published studies on this topic included patients up to 2009, 3,5,[10][11][12][13][14][15][16] and most other studies have not included more recent patients, while the treatment of BC patients is constantly evolving, such as the increased usage of neoadjuvant chemotherapy. Therefore, we have updated our cohort until 2016, analyzing data from virtually all patients with invasive BC treated with RC in Québec province between 2000 and 2016.…”