The feasibility of radical cystectomy in elderly patients

Görgel, Sacit Nuri; Şefik, Ertuğrul; Balcı, Uğur; Ozer, Kutan; Girgin, Cengiz; Dinçel, Çetin

doi:10.5152/tud.2014.09735

Cited by 5 publications

(6 citation statements)

References 31 publications

(32 reference statements)

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“…[6] mentioned that the complete response rates in patients receiving multimodal treatment have ranged from 47% to 87%, and 5-year overall survival rates have ranged from 30% to 70% in different studies. These outcomes are almost similar with the present report by Görgel et al; [1] who reported the 5-year overall survival rates 43.9% vs. 45.9% with RC for patients over and under 70 years of age, respectively.…”

Section: The Role Of Bladder Preservation In This Group Of Patientssupporting

confidence: 93%

The feasibility of radical cystectomy in elderly patients

Şanlı

Böyük

2014

Turkish Journal of Urology

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Radical cystectomy (RC) with urinary diversion is the gold standard for muscle-invasive bladder cancer (MIBC). The study by Görgel et al. [1] revealed that RC may be performed with acceptable morbidity even in patients over 70 years of age. Meanwhile, the authors also reported comparable oncological outcomes in this group of patients relative to their younger counterparts. We think that the following issues in this group of patients should be discussed.

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Section: The Role Of Bladder Preservation In This Group Of Patientssupporting

confidence: 93%

The feasibility of radical cystectomy in elderly patients

Şanlı

Böyük

2014

Turkish Journal of Urology

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“…17 , 18 Similar age threshold was adopted in a study of Görgel et al which evaluated the outcomes of RC among elderly patients in Turkey. 19 …”

Section: Discussionmentioning

confidence: 99%

Increased One-Year Mortality Among Elderly Patients After Radical Cystectomy for Muscle-Invasive Bladder Cancer: A Retrospective, Observational Comparative Study

Lemiński

Kaczmarek

Gołąb

et al. 2022

CIA

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Introduction Muscle invasive bladder cancer (MIBC) is a common malignancy amongst elderly. Increasing life expectancy, prevalence of smoking, lifelong exposure to environmental pollutants and immunosenescence contribute to growing number of cases. Traditionally, radical cystectomy (RC) with pelvic lymph node dissection (PLND) constituted the mainstay of treatment for MIBC, but despite proven feasibility in elderly population, it has been associated with significant burden of morbidity, mortality, and complications. Study Objective We aimed to re-evaluate the safety and efficacy of RC amongst the elderly patients with MIBC. Material and Methods This single-center, retrospective, observational comparative study was conducted among 568 patients who underwent RC due to MIBC between 2003 and 2021. We evaluated the influence of chronological age (<70 vs ≥70 years) on clinical, demographic, and pathological variables related to MIBC and RC. Results Elderly patients had similar clinical and pathological features of disease compared to their younger counterparts; nonetheless, they more often received simplified urinary diversion, ie ureterostomy (60.25% vs 39.33%, p<0.001) and had no PLND (15.76% vs 8.5%, p=0.01) during RC. Furthermore, more elderly patients were treated for secondary MIBCs and fewer had history of smoking. Severe complication and 90-day mortality rates were comparable between groups; however, the elderly had significantly higher all-cause mortality at one year post RC (46.67% vs 33.25%, p=0.003). On multivariate analysis, one-year mortality risk was independently associated with elderly age (HR=2.119, 95% CI: 1.227–3.660, p=0.007), rural residency (HR=1.760, 95% CI: 1.043–2.968, p=0.034), extravesical extension of tumor (HR=2.109, 95% CI: 1.155–3.850, p=0.015), lymph node metastasis (HR=2.268, 95% CI: 1.290–3.987, p=0.004) and omission of PLND (HR=6.064, 95% CI: 2.926–12.568, p<0.001). Conclusion Radical cystectomy in elderly patients is associated with significant one-year mortality. Our study emphasizes the unmet need for considerate planning of treatment for MIBC in potentially vulnerable groups of elderly patients. Efforts are needed to reliably identify those unlikely to benefit from surgery and facilitate patient-centered choice of alternative therapies.

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“…Similar with RCC surgery, a recent study from Turkey found that oncological outcomes of radical cystectomy were comparable between young and elderly patients (cut-off value 70 years of age) and age should not constitute a contraindication for radical cystectomy operations. 29 The first limitation of the current study is being a single-center experience and its retro-spective design. Secondly, the sample size of the groups is relatively small.…”

Section: Discussionmentioning

confidence: 97%