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Evaluation and Management of the Geriatric Urologic Oncology Patient

  • Geriatric Urology (TJ Guzzo and DJ Canter, Section Editors)
  • Published:
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Abstract

The geriatric population presents a unique set of challenges in urologic oncology. In addition to the known natural history of disease, providers must also consider patient factors such as functional and nutritional status, comorbidities and social support when determining the treatment plan. The development of frailty measures and biomarkers to estimate surgical risk shows promise, with several assessment tools predictive of surgical complications. Decreased dependence on chronologic age is important when assessing surgical fitness, as age cutoffs prevent appropriate treatment of many elderly patients who would benefit from surgery. Within bladder, kidney and prostate cancers, continued refinement of surgical techniques offers a broader array of options for the geriatric patient than previously available.

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References

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  1. Zbar AP, Gravitz A, Audisio RA. Principles of surgical oncology in the elderly. Clin Geriatr Med. 2012;28(1):51. doi:10.1016/j.cger.2011.09.002.

    Article  PubMed  Google Scholar 

  2. National Cancer Institute. Surveillance, epidemiology, and end results program (SEER) fact sheet. www.seer.cancer.gov. Updated 2014. Accessed 05/23, 2014.

  3. Wilson JRM, Clarke MG, Ewings P, Graham JD, MacDonagh R. The assessment of patient life-expectancy: How accurate are urologists and oncologists? BJU Int. 2005;95(6):794–8. doi:10.1111/j.1464-410X.2005.05403.x.

    Article  PubMed  Google Scholar 

  4. Firat S, Bousamra M, Gore E, Byhardt RW. Comorbidity and KPS are independent prognostic factors in stage I non-small-cell lung cancer. Int J Radiat Oncol Biol Phys. 2002;52(4):1047–57.

    Article  PubMed  Google Scholar 

  5. Peek ME. Screening mammography in the elderly: A review of the issues. J Am Med Womens Assoc. 2003;58(3):191–8.

    PubMed  Google Scholar 

  6. Davenport DL, Bowe EA, Henderson WG, Khuri SF, Mentzer Jr RM. National surgical quality improvement program (NSQIP) risk factors can be used to validate American society of anesthesiologists physical status classification (ASA PS) levels. Ann Surg. 2006;243(5):636–41. Accessed 4 June 2014.

    Article  PubMed Central  PubMed  Google Scholar 

  7. Mak PH, Campbell RC, Irwin MG, American Society of Anesthesiologists. The ASA physical status classification: Inter-observer consistency. American society of anesthesiologists. Anaesth Intensive Care. 2002;30(5):633–40.

    CAS  PubMed  Google Scholar 

  8. Revenig LM, Ogan K, Guzzo TJ, Canter DJ. The use of frailty as a surgical risk assessment tool in elderly patients. Curr Geriatr Rep. 2014;3(1):1–7.

    Article  Google Scholar 

  9. Extermann M, Aapro M, Bernabei R, et al. Use of comprehensive geriatric assessment in older cancer patients: Recommendations from the task force on CGA of the international society of geriatric oncology (SIOG). Crit Rev Oncol. 2005;55(3):241–52.

    Article  Google Scholar 

  10. Kim S, Han H, Jung H, et al. Multidimensional frailty score for the prediction of postoperative mortality risk. JAMA surgery. 2014.

  11. Pope D, Ramesh H, Gennari R, et al. Pre-operative assessment of cancer in the elderly (PACE): A comprehensive assessment of underlying characteristics of elderly cancer patients prior to elective surgery. Surg Oncol. 2006;15(4):189–97.

    Article  CAS  PubMed  Google Scholar 

  12. Fried LP, Tangen CM, Walston J, et al. Frailty in older adults: Evidence for a phenotype. J Gerontol A Biol Sci Med Sci. 2001;56(3):M146–56.

    Article  CAS  PubMed  Google Scholar 

  13. Makary MA, Segev DL, Pronovost PJ, et al. Frailty as a predictor of surgical outcomes in older patients. J Am Coll Surg. 2010;210(6):901–8. The first large study using simple frailty measure as a predictor of postoperative complications.

    Article  PubMed  Google Scholar 

  14. Revenig LM, Canter DJ, Taylor MD, et al. Too frail for surgery? initial results of a large multidisciplinary prospective study examining preoperative variables predictive of poor surgical outcomes. J Am Coll Surg. 2013;217(4):665-670.e1. doi:10.1016/j.jamcollsurg.2013.06.012.

    Article  PubMed  Google Scholar 

  15. Moyer VA. Screening for prostate cancer: US preventive services task force recommendation statement. Ann Intern Med. 2012;157(2):120–34.

    Article  PubMed  Google Scholar 

  16. Carter HB, Albertsen PC, Barry MJ, et al. Early detection of prostate cancer: AUA guideline. J Urol. 2013;190(2):419–26.

    Article  PubMed Central  PubMed  Google Scholar 

  17. Drazer MW, Prasad SM, Huo D, et al. National trends in prostate cancer screening among older American men with limited 9‐year life expectancies: Evidence of an increased need for shared decision making. Cancer. 2014. Highlights the primary problem with PSA screening; its inappropriate use in very old men and those with limited life expectancies.

  18. Preventive US. Serv Task Force. Screening for prostate cancer: US preventive services task force recommendation statement. Ann Intern Med. 2008;149(3):185–91.

    Article  Google Scholar 

  19. Walter LC, Bertenthal D, Lindquist K, Konety BR. PSA screening among elderly men with limited life expectancies. JAMA. 2006;296(19):2336–42.

    Article  CAS  PubMed  Google Scholar 

  20. Vellekoop A, Loeb S. The utility of prostate-specific antigen screening and prostate cancer treatment in elderly patients. Curr Transl Geriatr ExpGerontol Rep. 2013;2(2):51–7.

    Article  CAS  Google Scholar 

  21. Mohler JL, Kantoff PW, Armstrong AJ, et al. Prostate cancer, version 2.2014. J Natl Compr Canc Netw. 2014;12(5):686–718.

    CAS  PubMed  Google Scholar 

  22. Daskivich TJ, Chamie K, Kwan L, et al. Comorbidity and competing risks for mortality in men with prostate cancer. Cancer. 2011;117(20):4642–50.

    Article  PubMed  Google Scholar 

  23. Scosyrev E, Messing E, Mohile S, Golijanin D, Wu G. Prostate cancer in the elderly: Frequency of advanced disease at presentation and disease-specific mortality. Int Braz j Urol. 2011;37(6):797–8.

    Article  Google Scholar 

  24. Schwartz KL, Alibhai SM, Tomlinson G, Naglie G, Krahn MD. Continued undertreatment of older men with localized prostate cancer. Urology. 2003;62(5):860–5.

    Article  PubMed  Google Scholar 

  25. Droz J, Balducci L, Bolla M, et al. Management of prostate cancer in older men: Recommendations of a working group of the international society of geriatric oncology. BJU Int. 2010;106(4):462–9.

    Article  PubMed Central  PubMed  Google Scholar 

  26. Rice KR, Colombo ML, Wingate J, et al. Low risk prostate cancer in men more than 70 years old: To treat or not to treat. Urol Oncol. 2013;31(6):755–760.

    Article  PubMed  Google Scholar 

  27. Mitsuzuka K, Koie T, FAU - Narita S, et al. Are pathological and oncological outcomes of elderly men treated with radical prostatectomy worse than those of younger men? matched-pair analysis between patients aged =70 years. - Jpn J Clin Oncol.2014. (1465-3621 (Electronic); 0368-2811 (Linking)).

  28. Alibhai SM, Naglie G, Nam R, Trachtenberg J, Krahn MD. Do older men benefit from curative therapy of localized prostate cancer? J Clin Oncol. 2003;21(17):3318–27. doi:10.1200/JCO.2003.09.034.

    Article  PubMed  Google Scholar 

  29. Rabbani F, Stapleton AM, Kattan MW, Wheeler TM, Scardino PT. Factors predicting recovery of erections after radical prostatectomy. J Urol. 2000;164(6):1929–34.

    Article  CAS  PubMed  Google Scholar 

  30. Sanda MG, Dunn RL, Michalski J, et al. Quality of life and satisfaction with outcome among prostate-cancer survivors. N Engl J Med. 2008;358(12):1250–61.

    Article  CAS  PubMed  Google Scholar 

  31. Begg CB, Riedel ER, Bach PB, et al. Variations in morbidity after radical prostatectomy. N Engl J Med. 2002;346(15):1138–44.

    Article  PubMed  Google Scholar 

  32. Zeliadt SB, Potosky AL, Penson DF, Etzioni R. Survival benefit associated with adjuvant androgen deprivation therapy combined with radiotherapy for high-and low-risk patients with nonmetastatic prostate cancer. Int J Radiat Oncol Biol Phys. 2006;66(2):395–402.

    Article  CAS  PubMed  Google Scholar 

  33. Kunkler IH, Audisio R, Belkacemi Y, et al. Review of current best practice and priorities for research in radiation oncology for elderly patients with cancer: The international society of geriatric oncology (SIOG) task force. Ann Oncol. 2014. doi:10.1093/annonc/mdu104.

  34. Studer UE, Collette L, Whelan P, et al. Using PSA to guide timing of androgen deprivation in patients with T0–4 N0–2 M0 prostate cancer not suitable for local curative treatment (EORTC 30891). Eur Urol. 2008;53(5):941–9.

    Article  PubMed  Google Scholar 

  35. Lebret T, Culine S, FAU - Davin J, et al. Quality of life of 1276 elderly patients with prostate cancer, starting treatment with a gonadotropin-releasing hormone agonist: Results of a french observational study. - Aging Male.2014 Feb 27. (1473-0790 (Electronic); 1368-5538 (Linking)).

  36. Schultzel M, Saltzstein SL, Downs TM, Shimasaki S, Sanders C, Sadler GR. Late age (85 years or older) peak incidence of bladder cancer. J Urol. 2008;179(4):1302–6.

    Article  PubMed Central  PubMed  Google Scholar 

  37. Hall MC, Chang SS, Dalbagni G, et al. Guideline for the management of nonmuscle invasive bladder cancer (stages ta, T1, and tis): 2007 update. J Urol. 2007;178(6):2314–30.

    Article  PubMed  Google Scholar 

  38. Mak RH, Zietman AL, Heney NM, Kaufman DS, Shipley WU. Bladder preservation: Optimizing radiotherapy and integrated treatment strategies. BJU Int. 2008;102(9b):1345–53.

    Article  PubMed  Google Scholar 

  39. Pietzak EJ, Drach GW, Malkowicz SB, Guzzo TJ. Optimal management of the elderly patient with muscle-invasive bladder cancer. Curr Transl Geriatr Exp Gerontol Rep. 2013;2(2):58–65.

    Article  Google Scholar 

  40. Chamie K, Hu B, DeVere White RW, Ellison LM. Cystectomy in the elderly: Does the survival benefit in younger patients translate to the octogenarians? BJU Int. 2008;102(3):284–90.

    Article  PubMed  Google Scholar 

  41. Isbarn H, Jeldres C, Zini L, et al. A population based assessment of perioperative mortality after cystectomy for bladder cancer. J Urol. 2009;182(1):70–7.

    Article  PubMed  Google Scholar 

  42. Donat SM, Siegrist T, Cronin A, Savage C, Milowsky MI, Herr HW. Radical cystectomy in octogenarians—does morbidity outweigh the potential survival benefits? J Urol. 2010;183(6):2171–7.

    Article  PubMed  Google Scholar 

  43. Mendiola FP, Zorn KC, Gofrit ON, et al. Cystectomy in the ninth decade: Operative results and long-term survival outcomes. Can J Urol. 2007;14(4):3628–34.

    PubMed  Google Scholar 

  44. Hollenbeck BK, Miller DC, Taub D, et al. Aggressive treatment for bladder cancer is associated with improved overall survival among patients 80 years old or older. Urology. 2004;64(2):292–7.

    Article  PubMed  Google Scholar 

  45. Prout GR, Wesley MN, Yancik R, Ries LA, Havlik RJ, Edwards BK. Age and comorbidity impact surgical therapy in older bladder carcinoma patients. Cancer. 2005;104(8):1638–47.

    Article  PubMed  Google Scholar 

  46. Rink M, Dahlem R, Kluth L, et al. Older patients suffer from adverse histopathological features after radical cystectomy. Int J Urol. 2011;18(8):576–84.

    Article  PubMed  Google Scholar 

  47. Berneking AD, Rosevear HM, Askeland EJ, Newton MR, O'Donnell MA, Brown JA. Morbidity and mortality of octogenarians following open radical cystectomy using a standardized reporting system. Can J Urol. 2013;20(4):6826–31.

    PubMed  Google Scholar 

  48. Froehner M, Brausi MA, Herr HW, Muto G, Studer UE. Complications following radical cystectomy for bladder cancer in the elderly. Eur Urol. 2009;56(3):443–54.

    Article  PubMed  Google Scholar 

  49. Liberman D, Lughezzani G, Sun M, et al. Perioperative mortality is significantly greater in septuagenarian and octogenarian patients treated with radical cystectomy for urothelial carcinoma of the bladder. Urology. 2011;77(3):660–6.

    Article  PubMed  Google Scholar 

  50. Lawrentschuk N, Colombo R, Hakenberg OW, et al. Prevention and management of complications following radical cystectomy for bladder cancer. Eur Urol. 2010;57(6):983–1001.

    Article  PubMed  Google Scholar 

  51. Richards KA, Kader AK, Otto R, Pettus JA, Smith III JJ, Hemal AK. Is robot-assisted radical cystectomy justified in the elderly? A comparison of robotic versus open radical cystectomy for bladder cancer in elderly ≥ 75 years old. J Endourol. 2012;26(10):1301–6.

    Article  PubMed  Google Scholar 

  52. Phillips EA, Uberoi V, Tuerk IA. Robot-assisted radical cystectomy in octogenarians. J Endourol. 2014;28(2):219–23. doi:10.1089/end.2013.0159.

    Article  PubMed  Google Scholar 

  53. Gore JL, Litwin MS. Quality of care in bladder cancer: Trends in urinary diversion following radical cystectomy. World J Urol. 2009;27(1):45–50.

    Article  PubMed Central  PubMed  Google Scholar 

  54. Van der Aa F, Joniau S, Van Den Branden M, Van Poppel H. Metabolic changes after urinary diversion. Adv Urol. 2011;2011:764325. doi:10.1155/2011/764325.

    PubMed Central  PubMed  Google Scholar 

  55. Lambert JW, Ingham M, Gibbs BB, Given RW, Lance RS, Riggs SB. Using preoperative albumin levels as a surrogate marker for outcomes after radical cystectomy for bladder cancer. Urology. 2013;81(3):587–92.

    Article  PubMed  Google Scholar 

  56. Van Kan GA, André E, Bischoff-Ferrari H, et al. Carla task force on sarcopenia: Propositions for clinical trials. JNHA- J Nutrit Health Aging. 2009;13(8):700–7.

    Article  Google Scholar 

  57. Psutka SP, Carrasco A, Schmit GD, et al. Sarcopenia in patients with bladder cancer undergoing radical cystectomy: Impact on cancer‐specific and all‐cause mortality. Cancer. 2014;120(18):2910–8.

    Article  PubMed  Google Scholar 

  58. Smith AB, Deal AM, Yu H, et al. Sarcopenia as a predictor for complications and survival following radical cystectomy. J Urol. 2014. doi:10.1016/j.juro.2013.12.047.

  59. Vale C. Neoadjuvant chemotherapy in invasive bladder cancer: Update of a systematic review and meta-analysis of individual patient data: Advanced bladder cancer (ABC) meta-analysis collaboration. Eur Urol. 2005;48(2):202–6.

    Article  Google Scholar 

  60. Keegan KA, Zaid HB, Patel SG, Chang SS. Increasing utilization of neoadjuvant chemotherapy for muscle-invasive bladder cancer in the united states. Curr Urol Rep. 2014;15(4):1–5.

    Article  Google Scholar 

  61. Galsky MD, Hahn NM, Rosenberg J, et al. A consensus definition of patients with metastatic urothelial carcinoma who are unfit for cisplatin-based chemotherapy. Lancet Oncol. 2011;12(3):211–4.

    Article  PubMed  Google Scholar 

  62. Ploussard G, Daneshmand S, Efstathiou JA, et al. Critical analysis of bladder sparing with trimodal therapy in muscle-invasive bladder cancer: A systematic review. Eur Urol. 2014;66(1):120–37. An excellent review article compiling all of the recent studies of bladder-sparing treatment for bladder cancer.

  63. Madersbacher S, Hochreiter W, Burkhard F, et al. Radical cystectomy for bladder cancer today–a homogeneous series without neoadjuvant therapy. J Clin Oncol. 2003;21(4):690–6.

    Article  PubMed  Google Scholar 

  64. Culp SH, Dickstein RJ, Grossman HB, et al. Refining patient selection for neoadjuvant chemotherapy before radical cystectomy. J Urol. 2014;191(1):40–7.

    Article  PubMed Central  PubMed  Google Scholar 

  65. Turgeon G, Souhami L, Cury FL, et al. Hypofractionated intensity modulated radiation therapy in combined modality treatment for bladder preservation in elderly patients with invasive bladder cancer. Int J Radiat Oncol Biol Phys. 2014;88(2):326–31. doi:10.1016/j.ijrobp.2013.11.005.

    Article  PubMed  Google Scholar 

  66. Wehrberger C, Berger I, Marszalek M, et al. Bladder preservation in octogenarians with invasive bladder cancer. Urology. 2010;75(2):370–5.

    Article  PubMed  Google Scholar 

  67. Volpe A, Panzarella T, Rendon RA, Haider MA, Kondylis FI, Jewett MA. The natural history of incidentally detected small renal masses. Cancer. 2004;100(4):738–45.

    Article  PubMed  Google Scholar 

  68. Chow WH, Devesa SS. Contemporary epidemiology of renal cell cancer. Cancer J. 2008;14(5):288–301. doi:10.1097/PPO.0b013e3181867628.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  69. Hollingsworth JM, Miller DC, Daignault S, Hollenbeck BK. Rising incidence of small renal masses: A need to reassess treatment effect. J Natl Cancer Inst. 2006;98(18):1331–4.

    Article  PubMed  Google Scholar 

  70. Wagstaff P, Zondervan P, de la Rosette J, Laguna M. The role of imaging in the active surveillance of small renal masses. Curr Urol Rep. 2014;15(3):1–8.

    Article  Google Scholar 

  71. Remzi M, Özsoy M, Klingler H, et al. Are small renal tumors harmless? analysis of histopathological features according to tumors 4 cm or less in diameter. J Urol. 2006;176(3):896–9.

    Article  PubMed  Google Scholar 

  72. Crispen PL, Boorjian SA, Lohse CM, et al. Outcomes following partial nephrectomy by tumor size. J Urol. 2008;180(5):1912–7.

    Article  PubMed  Google Scholar 

  73. Lane BR, Abouassaly R, Gao T, et al. Active treatment of localized renal tumors may not impact overall survival in patients aged 75 years or older. Cancer. 2010;116(13):3119–26.

    Article  PubMed  Google Scholar 

  74. Kutikov A, Egleston BL, Canter D, Smaldone MC, Wong Y, Uzzo RG. Competing risks of death in patients with localized renal cell carcinoma: A comorbidity based model. J Urol. 2012;188(6):2077–83. A useful nomogram to determine if a patient’s comorbidities provide enough of a competing risk to negate the benefit of nephrectomy.

    Article  PubMed  Google Scholar 

  75. Crispen PL, Viterbo R, Fox EB, Greenberg RE, Chen DY, Uzzo RG. Delayed intervention of sporadic renal masses undergoing active surveillance. Cancer. 2008;112(5):1051–7.

    Article  PubMed  Google Scholar 

  76. Abouassaly R, Lane BR, Novick AC. Active surveillance of renal masses in elderly patients. J Urol. 2008;180(2):505–9.

    Article  PubMed  Google Scholar 

  77. Crispen PL, Viterbo R, Boorjian SA, Greenberg RE, Chen DY, Uzzo RG. Natural history, growth kinetics, and outcomes of untreated clinically localized renal tumors under active surveillance. Cancer. 2009;115(13):2844–52.

    Article  PubMed Central  PubMed  Google Scholar 

  78. Smaldone MC, Kutikov A, Egleston BL, et al. Small renal masses progressing to metastases under active surveillance. Cancer. 2012;118(4):997–1006.

    Article  PubMed  Google Scholar 

  79. Donat SM, Diaz M, Bishoff JT, et al. Follow-up for clinically localized renal neoplasms: AUA guideline. J Urol. 2013;190(2):407–16.

    Article  PubMed  Google Scholar 

  80. Pierorazio PM, Hyams ES, Mullins JK, Allaf ME. Active surveillance for small renal masses. Rev Urol. 2012;14(1–2):13.

    PubMed Central  PubMed  Google Scholar 

  81. Campbell SC, Novick AC, Belldegrun A, et al. Guideline for management of the clinical T1 renal mass. J Urol. 2009;182(4):1271–9.

    Article  PubMed  Google Scholar 

  82. Huang WC, Elkin EB, Levey AS, Jang TL, Russo P. Partial nephrectomy versus radical nephrectomy in patients with small renal tumors—is there a difference in mortality and cardiovascular outcomes? J Urol. 2009;181(1):55–62.

    Article  PubMed Central  PubMed  Google Scholar 

  83. McKiernan J, Simmons R, Katz J, Russo P. Natural history of chronic renal insufficiency after partial and radical nephrectomy. Urology. 2002;59(6):816–20.

    Article  PubMed  Google Scholar 

  84. Thompson RH, Boorjian SA, Lohse CM, et al. Radical nephrectomy for pT1a renal masses may be associated with decreased overall survival compared with partial nephrectomy. J Urol. 2008;179(2):468–73.

    Article  PubMed  Google Scholar 

  85. Sun M, Bianchi M, Trinh Q, et al. Comparison of partial vs radical nephrectomy with regard to other‐cause mortality in T1 renal cell carcinoma among patients aged≥ 75 years with multiple comorbidities. BJU Int. 2013;111(1):67–73. Emphasizes the importance of comorbidities in predicting mortality following radical and partial nephrectomy.

    Article  PubMed  Google Scholar 

  86. Simhan J, Smaldone MC, Tsai KJ, et al. Objective measures of renal mass anatomic complexity predict rates of major complications following partial nephrectomy. Eur Urol. 2011;60(4):724–30.

    Article  PubMed Central  PubMed  Google Scholar 

  87. Van Poppel H, Da Pozzo L, Albrecht W, et al. A prospective, randomised EORTC intergroup phase 3 study comparing the oncologic outcome of elective nephron-sparing surgery and radical nephrectomy for low-stage renal cell carcinoma. Eur Urol. 2011;59(4):543–52.

    Article  PubMed  Google Scholar 

  88. Tomaszewski JJ, Uzzo RG, Kutikov A, et al. Assessing the burden of complications after surgery for clinically localized kidney cancer by age and comorbidity status. Urology. 2014;83(4):843–50.

    Article  PubMed  Google Scholar 

  89. Ficarra V, Minervini A, Antonelli A, et al. A multicenter Matched‐Pair analysis comparing Robot‐Assisted versus open partial nephrectomy. BJU Int. 2014;113(6):936–41.

    Article  CAS  PubMed  Google Scholar 

  90. Gill IS, Patil MB, de Castro Abreu AL, et al. Zero ischemia anatomical partial nephrectomy: A novel approach. J Urol. 2012;187(3):807–15.

    Article  PubMed  Google Scholar 

  91. Gunn AJ, Gervais DA. Percutaneous ablation of the small renal mass—techniques and outcomes. Semin Intervent Radiol. 2014;31(01):033–041.

    Article  Google Scholar 

  92. Olweny EO, Park SK, Tan YK, Best SL, Trimmer C, Cadeddu JA. Radiofrequency ablation versus partial nephrectomy in patients with solitary clinical T1a renal cell carcinoma: Comparable oncologic outcomes at a minimum of 5 years of follow-up. Eur Urol. 2012;61(6):1156–61.

    Article  PubMed  Google Scholar 

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Conflict of Interest

Maxim J. McKibben declares that he has no conflict of interest.

Angela B. Smith has received research support through grants from the National Center for Advancing Translational Sciences (NCATS) at the National Institutes of Health (NIH) (Grant KL2TR001109) and the University Cancer Research Fund.

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This article does not contain any studies with human or animal subjects performed by any of the authors.

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  1. Department of Urology, University of North Carolina at Chapel Hill, 170 Manning Drive, 2115 Physicians Office Building, CB#7235, Chapel Hill, NC, 27599-7235, USA

    Maxim J. McKibben & Angela B. Smith

  2. Lineberger Comprehensive Cancer Center, Cancer Outcomes Research Group, Multidisciplinary Genitourinary Oncology, Chapel Hill, NC, USA

    Maxim J. McKibben & Angela B. Smith

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  1. Maxim J. McKibben
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  2. Angela B. Smith
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Correspondence to Angela B. Smith.

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McKibben, M.J., Smith, A.B. Evaluation and Management of the Geriatric Urologic Oncology Patient. Curr Geri Rep 4, 7–15 (2015). https://doi.org/10.1007/s13670-014-0106-5

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