Bladder Cancer

  • Daniel J. Lee
  • Shahrokh Shariat
  • Jeffrey M. HolzbeierleinEmail author


Bladder cancer is a disease which primarily affects older patients with a median age of 70 years. In addition, many of these patients have significant comorbidities which may affect not only treatment options but also a patient’s response to treatment. Considerations regarding the physiologic changes that are particular to older patients undergoing treatment for bladder cancer are critical for the urologist to understand. Also, it is critical to recognize the preoperative, intraoperative, and postoperative needs of older patients undergoing cystectomy with particular attention to posthospital care. Furthermore, the choice of diversion has special implications in older patients. Finally, other options such as chemotherapy have special consideration in older patients and require an in-depth understanding of issues in older populations.


Bladder Cancer Radical Cystectomy Urinary Diversion Mini Nutritional Assessment Skilled Nursing Facility 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


  1. 1.
    Jemal A, Bray F, Center MM, Ferlay J, Ward E, Forman D. Global cancer statistics. CA Cancer J Clin. 2011;61:69–90.PubMedGoogle Scholar
  2. 2.
    Siegel R, Ward E, Brawley O, Jemal A. Cancer statistics, 2011: the impact of eliminating socioeconomic and racial disparities on premature cancer deaths. CA Cancer J Clin. 2011;61:212–36.PubMedGoogle Scholar
  3. 3.
    Shariat SF, Tokunaga H, Zhou J, et al. p53, p21, pRB, and p16 expression predict clinical outcome in cystectomy with bladder cancer. J Clin Oncol. 2004;22:1014–24.PubMedGoogle Scholar
  4. 4.
    Shariat SF, Casella R, Wians Jr FH, et al. Risk stratification for bladder tumor recurrence, stage and grade by urinary nuclear matrix protein 22 and cytology. Eur Urol. 2004;45:304–13. author reply 13.PubMedGoogle Scholar
  5. 5.
    Lotan Y, Shariat SF. Impact of risk factors on the performance of the nuclear matrix protein 22 point-of-care test for bladder cancer detection. BJU Int. 2008;101:1362–7.PubMedGoogle Scholar
  6. 6.
    Bochner BH. Optimal timing of radical cystectomy for patients with T1 bladder cancer. Urol Oncol. 2009;27:329–31.PubMedGoogle Scholar
  7. 7.
    Dalbagni G, Vora K, Kaag M, et al. Clinical outcome in a contemporary series of restaged patients with clinical T1 bladder cancer. Eur Urol. 2009;56:903–10.PubMedGoogle Scholar
  8. 8.
    Shariat SF, Karakiewicz PI, Palapattu GS, et al. Outcomes of radical cystectomy for transitional cell carcinoma of the bladder: a contemporary series from the bladder cancer research consortium. J Urol. 2006;176:2414–22. discussion 22.PubMedGoogle Scholar
  9. 9.
    Stein JP, Lieskovsky G, Cote R, et al. Radical cystectomy in the treatment of invasive bladder cancer: long-term results in 1,054 patients. J Clin Oncol. 2001;19:666–75.PubMedGoogle Scholar
  10. 10.
    Madersbacher S, Hochreiter W, Burkhard F, et al. Radical cystectomy for bladder cancer today–a homogeneous series without neoadjuvant therapy. J Clin Oncol. 2003;21:690–6.PubMedGoogle Scholar
  11. 11.
    Bochner BH, Kattan MW, Vora KC. Postoperative nomogram predicting risk of recurrence after radical cystectomy for bladder cancer. J Clin Oncol. 2006;24:3967–72.PubMedGoogle Scholar
  12. 12.
    Karakiewicz PI, Shariat SF, Palapattu GS, et al. Nomogram for predicting disease recurrence after radical cystectomy for transitional cell carcinoma of the bladder. J Urol. 2006;176:1354–61. discussion 61–2.PubMedGoogle Scholar
  13. 13.
    Shariat SF, Karakiewicz PI, Palapattu GS, et al. Nomograms provide improved accuracy for predicting survival after radical cystectomy. Clin Cancer Res. 2006;12:6663–76.PubMedGoogle Scholar
  14. 14.
    Chromecki TF, Mauermann J, Cha EK, et al. Multicenter validation of the prognostic value of patient age in patients treated with radical cystectomy. World J Urol. 2012;30(6):753–9.PubMedGoogle Scholar
  15. 15.
    Shariat SF, Milowsky M, Droller MJ. Bladder cancer in the elderly. Urol Oncol. 2009;27:653–67.PubMedGoogle Scholar
  16. 16.
    Shariat SF, Sfakianos JP, Droller MJ, Karakiewicz PI, Meryn S, Bochner BH. The effect of age and gender on bladder cancer: a critical review of the literature. BJU Int. 2010;105:300–8.PubMedGoogle Scholar
  17. 17.
    Messing EM. Urothelial tumors of the bladder. In: Wein AJ, Kavoussi LR, Novick AC, Partin AW, Peters CA, editors. Campbell-walsh urology, vol. Chapter 75. 9th ed. Philadelphia, PA: Saunders-Elsevier; 2008. p. 2407–46.Google Scholar
  18. 18.
    American Cancer Society. Cancer facts and figures 2008. Atlanta: American Cancer Society; 2008.Google Scholar
  19. 19.
    Kent MM, Mather M. What drives US population growth? Population Bull. 2002;57:1–40.Google Scholar
  20. 20.
    Kinsella K, Velkoff VA. An aging world: 2005 US Census Bureau, series P95/005-1. Washington, DC: US Government Printing Office; 2005.Google Scholar
  21. 21.
    UBoCw. Accessed 10 Nov 2008.
  22. 22.
    Yancik R, Ries LA. Cancer in older persons: an international issue in an aging world. Semin Oncol. 2004;31:128–36.PubMedGoogle Scholar
  23. 23.
    Havlik RJ, Yancik R, Long S, Ries L, Edwards B. The National Institute on Aging and the National Cancer Institute SEER collaborative study on comorbidity and early diagnosis of cancer in the elderly. Cancer. 1994;74:2101–6.PubMedGoogle Scholar
  24. 24.
    Yancik R, Ries LA. Aging and cancer in America. Demographic and epidemiologic perspectives. Hematol Oncol Clin North Am. 2000;14:17–23.PubMedGoogle Scholar
  25. 25.
    Edwards BK, Howe HL, Ries LA, et al. Annual report to the nation on the status of cancer, 1973–1999, featuring implications of age and aging on U.S. cancer burden. Cancer. 2002;94:2766–92.PubMedGoogle Scholar
  26. 26.
    Hewitt M, Rowland JH, Yancik R. Cancer survivors in the United States: age, health, and disability. J Gerontol A Biol Sci Med Sci. 2003;58:82–91.PubMedGoogle Scholar
  27. 27.
    Jaklitsch MT, Bueno R, Swanson SJ, Mentzer SJ, Lukanich JM, Sugarbaker DJ. New surgical options for elderly lung cancer patients. Chest. 1999;116:480S–5.PubMedGoogle Scholar
  28. 28.
    Froehner M, Brausi MA, Herr HW, Muto G, Studer UE. Complications following radical cystectomy for bladder cancer in the elderly. Eur Urol. 2009;56:443–54.PubMedGoogle Scholar
  29. 29.
    Isbarn H, Jeldres C, Zini L, et al. A population based assessment of perioperative mortality after cystectomy for bladder cancer. J Urol. 2009;182:70–7.PubMedGoogle Scholar
  30. 30.
    Shariat SF, Godoy G, Lotan Y, et al. Advanced patient age is associated with inferior cancer-specific survival after radical nephroureterectomy. BJU Int. 2009;105(12):1672–7.PubMedGoogle Scholar
  31. 31.
    Whitmore Jr WF, Marshall VF. Radical total cystectomy for cancer of the bladder: 230 consecutive cases five years later. J Urol. 1962;87:853–68.PubMedGoogle Scholar
  32. 32.
    Sawhney R, Sehl M, Naeim A. Physiologic aspects of aging: impact on cancer management and decision making, part I. Cancer J. 2005;11:449–60.PubMedGoogle Scholar
  33. 33.
    Sehl M, Sawhney R, Naeim A. Physiologic aspects of aging: impact on cancer management and decision making, part II. Cancer J. 2005;11:461–73.PubMedGoogle Scholar
  34. 34.
    Hurria AMH, Cohen HJ, editors. Cancer and aging (Chapter 75). Hamilton: BC Decker; 2003.Google Scholar
  35. 35. 2008. Accessed 14 Dec 2008.
  36. 36.
    Hazen SE, Larsen PD, Martin JL. General anesthesia and elderly surgical patients. AORN J. 1997;65(815–9):21–2.Google Scholar
  37. 37.
    Malani PN, Vaitkevicius P, Orringer MB. Perioperative evaluation, and management. Chapter 35. In: Halter JB, Ouslander J, Tinetti ME, Studenski S, High KP, Asthana S editors. Accessed 25 Oct 2009.
  38. 38.
    Hardin RE. ZMCSCitEIBF. In: Andersen DK, Billiar TR, Dunn DL, Hunter JG, Matthews JB, Pollock RE, editors. Schwartz’s principles of surgery. 9th ed. New York, NY: McGraw-Hill; 2011. Accessed 24 Oct 2011.
  39. 39.
    Pedelty L, Gorelick PB. Management of hypertension and cerebrovascular disease in the elderly. Am J Med. 2008;121:S23–31.PubMedGoogle Scholar
  40. 40.
    Baruch L. Hypertension and the elderly: more than just blood pressure control. J Clin Hypertens (Greenwich). 2004;6:249–55.Google Scholar
  41. 41.
    Watters JM. Surgery in the elderly. Can J Surg. 2002;45:104–8.PubMedCentralPubMedGoogle Scholar
  42. 42.
    Ergina PL, Gold SL, Meakins JL. Perioperative care of the elderly patient. World J Surg. 1993;17:192–8.PubMedGoogle Scholar
  43. 43.
    Loran DB, Zwischenberger JB. Thoracic surgery in the elderly. J Am Coll Surg. 2004;199:773–84.PubMedGoogle Scholar
  44. 44.
    Sharma G, Goodwin J. Effect of aging on respiratory system physiology and immunology. Clin Interv Aging. 2006;1:253–60.PubMedCentralPubMedGoogle Scholar
  45. 45.
    Lawrence VA, Cornell JE, Smetana GW. Strategies to reduce postoperative pulmonary complications after noncardiothoracic surgery: systematic review for the American College of Physicians. Ann Intern Med. 2006;144:596–608.PubMedGoogle Scholar
  46. 46.
    Muhlberg W, Platt D. Age-dependent changes of the kidneys: pharmacological implications. Gerontology. 1999;45:243–53.PubMedGoogle Scholar
  47. 47.
    Turnheim K. When drug therapy gets old: pharmacokinetics and pharmacodynamics in the elderly. Exp Gerontol. 2003;38:843–53.PubMedGoogle Scholar
  48. 48.
    Pasetto LM, Lise M, Monfardini S. Preoperative assessment of elderly cancer patients. Crit Rev Oncol Hematol. 2007;64:10–8.PubMedGoogle Scholar
  49. 49.
    Stevens LA, Li S, Kurella Tamura M, et al. Comparison of the CKD epidemiology collaboration (CKD-EPI) and modification of diet in renal disease (MDRD) study equations: risk factors for and complications of CKD and mortality in the kidney early evaluation program (KEEP). Am J Kidney Dis. 2011;57:S9–16.PubMedCentralPubMedGoogle Scholar
  50. 50.
    Madero M, Sarnak MJ. Creatinine-based formulae for estimating glomerular filtration rate: is it time to change to Chronic Kidney Disease Epidemiology Collaboration Equation? Curr Opin Nephrol Hypertens. 2011;20:622–30.PubMedGoogle Scholar
  51. 51.
    Weinberger B, Herndler-Brandstetter D, Schwanninger A, Weiskopf D, Grubeck-Loebenstein B. Biology of immune responses to vaccines in elderly persons. Clin Infect Dis. 2008;46:1078–84.PubMedGoogle Scholar
  52. 52.
    Fulop T, Larbi A, Hirokawa K, et al. Immuno-supportive therapies in aging. Clin Interv Aging. 2007;2:33–54.PubMedCentralPubMedGoogle Scholar
  53. 53.
    Kumar R, Burns EA. Age-related decline in immunity: implications for vaccine responsiveness. Expert Rev Vaccines. 2008;7:467–79.PubMedGoogle Scholar
  54. 54.
    Wu D, Meydani SN. Age-associated changes in immune and inflammatory responses: impact of vitamin E intervention. J Leukoc Biol. 2008;84:900–14.PubMedCentralPubMedGoogle Scholar
  55. 55.
    Nass R, Johannsson G, Christiansen JS, Kopchick JJ, Thorner MO. The aging population–is there a role for endocrine interventions? Growth Horm IGF Res. 2009;19:89–100.PubMedGoogle Scholar
  56. 56.
    Ferrucci L. SSCCPoAILD. In: Fauci AS, Kasper DL, Hauser SL, Jameson JL, Loscalzo J, editors. Harrison’s principles of internal medicine. 18th ed. New York, NY: McGraw-Hill; 2011. Accessed 25 Oct 2011.
  57. 57.
    Rantanen T, Masaki K, Foley D, Izmirlian G, White L, Guralnik JM. Grip strength changes over 27 yr in Japanese-American men. J Appl Physiol. 1998;85:2047–53.PubMedGoogle Scholar
  58. 58.
    Rosenthal RA. Nutritional concerns in the older surgical patient. J Am Coll Surg. 2004;199:785–91.PubMedGoogle Scholar
  59. 59.
    Mainous MR, Deitch EA. Nutrition and infection. Surg Clin North Am. 1994;74:659–76.PubMedGoogle Scholar
  60. 60.
    Gregg JR, Cookson MS, Phillips S, et al. Effect of preoperative nutritional deficiency on mortality after radical cystectomy for bladder cancer. J Urol. 2011;185:90–6.PubMedCentralPubMedGoogle Scholar
  61. 61.
    Vellas B, Villars H, Abellan G, et al. Overview of the MNA–Its history and challenges. J Nutr Health Aging. 2006;10:456–63. discussion 63–5.PubMedGoogle Scholar
  62. 62.
    Rubenstein LZ, Harker JO, Salva A, Guigoz Y, Vellas B. Screening for undernutrition in geriatric practice: developing the short-form mini-nutritional assessment (MNA-SF). J Gerontol A Biol Sci Med Sci. 2001;56:M366–72.PubMedGoogle Scholar
  63. 63.
    Guigoz Y. The mini nutritional assessment (MNA) review of the literature–what does it tell us? J Nutr Health Aging. 2006;10:466–85. discussion 85–7.PubMedGoogle Scholar
  64. 64.
    Raz N, Rodrigue KM, Haacke EM. Brain aging and its modifiers: insights from in vivo neuromorphometry and susceptibility weighted imaging. Ann N Y Acad Sci. 2007;1097:84–93.PubMedCentralPubMedGoogle Scholar
  65. 65.
    Extermann M, Hurria A. Comprehensive geriatric assessment for older patients with cancer. J Clin Oncol. 2007;25:1824–31.PubMedGoogle Scholar
  66. 66.
    Finlayson E. BJCSOIHJ. In: Ouslander JG, Tinetti ME, Studenski S, High KP, Asthana S, editors. Hazzard’s geriatric medicine and gerontology. 6th ed. New York, NY: McGraw-Hill; 2011. Accessed 26 Oct 2011.
  67. 67.
    Newman MF, Kirchner JL, Phillips-Bute B, et al. Longitudinal assessment of neurocognitive function after coronary-artery bypass surgery. N Engl J Med. 2001;344:395–402.PubMedGoogle Scholar
  68. 68.
    Reuben DB, Rubenstein LV, Hirsch SH, Hays RD. Value of functional status as a predictor of mortality: results of a prospective study. Am J Med. 1992;93:663–9.PubMedGoogle Scholar
  69. 69.
    Hennessy D, Juzwishin K, Yergens D, Noseworthy T, Doig C. Outcomes of elderly survivors of intensive care: a review of the literature. Chest. 2005;127:1764–74.PubMedGoogle Scholar
  70. 70.
    Montuclard L, Garrouste-Orgeas M, Timsit JF, Misset B, De Jonghe B, Carlet J. Outcome, functional autonomy, and quality of life of elderly patients with a long-term intensive care unit stay. Crit Care Med. 2000;28:3389–95.PubMedGoogle Scholar
  71. 71.
    Vazquez Mata G, Rivera Fernandez R, Gonzalez Carmona A, et al. Factors related to quality of life 12 months after discharge from an intensive care unit. Crit Care Med. 1992;20:1257–62.PubMedGoogle Scholar
  72. 72.
    Weizer AZ, Joshi D, Daignault S, et al. Performance status is a predictor of overall survival of elderly patients with muscle invasive bladder cancer. J Urol. 2007;177:1287–93.PubMedGoogle Scholar
  73. 73.
    Williams SLJP, Pofahl WE. Preoperative management of the older patient-A surgeon’s perspective: part 1. Clin Geriatr Med. 2006;14:24.Google Scholar
  74. 74.
    Want J, Kamas G, Nguyen TN. Disease management in the frail and elderly population: integration of physicians in the intervention. Dis Manag. 2008;11:23–8.PubMedGoogle Scholar
  75. 75.
    Balducci L. Aging, frailty, and chemotherapy. Cancer Control. 2007;14:7–12.PubMedGoogle Scholar
  76. 76.
    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:M146–56.PubMedGoogle Scholar
  77. 77.
    Walston J, Fried LP. Frailty and the older man. Med Clin North Am. 1999;83:1173–94.PubMedGoogle Scholar
  78. 78.
    Wolff JL, Starfield B, Anderson G. Prevalence, expenditures, and complications of multiple chronic conditions in the elderly. Arch Intern Med. 2002;162:2269–76.PubMedGoogle Scholar
  79. 79.
    Satariano WA, Ragland DR. The effect of comorbidity on 3-year survival of women with primary breast cancer. Ann Intern Med. 1994;120:104–10.PubMedGoogle Scholar
  80. 80.
    Katz S, Ford AB, Moskowitz RW, Jackson BA, Jaffe MW. Studies of illness in the aged. The index of ADL: a standardized measure of biological and psychosocial function. JAMA. 1963;185:914–9.PubMedGoogle Scholar
  81. 81.
    Lawton MP. Scales to measure competence in everyday activities. Psychopharmacol Bull. 1988;24:609–14.PubMedGoogle Scholar
  82. 82.
    Mahoney FI, Barthel DW. Functional evaluation: the Barthel Index. Md State Med J. 1965;14:61–5.PubMedGoogle Scholar
  83. 83.
    Keith RA, Granger CV, Hamilton BB, Sherwin FS. The Functional Independence Measure: a new tool for rehabilitation. Adv Clin Rehabil. 1987;1:6–18.PubMedGoogle Scholar
  84. 84.
    Guralnik JM, Simonsick EM, Ferrucci L, et al. A short physical performance battery assessing lower extremity function: association with self-reported disability and prediction of mortality and nursing home admission. J Gerontol. 1994;49:M85–94.PubMedGoogle Scholar
  85. 85.
    Berg KO, Wood-Dauphinee SL, Williams JI, Maki B. Measuring balance in the elderly: validation of an instrument. Can J Public Health. 1992;83 Suppl 2:S7–11.PubMedGoogle Scholar
  86. 86.
    Studenski S. Bradypedia: is gait speed ready for clinical use? J Nutr Health Aging. 2009;13:878–80.PubMedGoogle Scholar
  87. 87.
    Guyatt GH, Sullivan MJ, Thompson PJ, et al. The 6-minute walk: a new measure of exercise capacity in patients with chronic heart failure. Can Med Assoc J. 1985;132:919–23.PubMedCentralPubMedGoogle Scholar
  88. 88.
    Newman AB, Simonsick EM, Naydeck BL, et al. Association of long-distance corridor walk performance with mortality, cardiovascular disease, mobility limitation, and disability. JAMA. 2006;295:2018–26.PubMedGoogle Scholar
  89. 89.
    Brandtstadter J, Renner G. Tenacious goal pursuit and flexible goal adjustment: explication and age-related analysis of assimilative and accommodative strategies of coping. Psychol Aging. 1990;5:58–67.PubMedGoogle Scholar
  90. 90.
    Lockenhoff CE, Carstensen LL. Socioemotional selectivity theory, aging, and health: the increasingly delicate balance between regulating emotions and making tough choices. J Pers. 2004;72:1395–424.PubMedGoogle Scholar
  91. 91.
    Halter JB, Ouslander J, Tinetti ME, Studenski S, High KP, Asthana S. Hazzard’s Geriatric Medicine and Gerontology, 6th Ed. New York, NY: McGraw-Hill; 2009.
  92. 92.
    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;179:1302–5. discussion 5–6.PubMedCentralPubMedGoogle Scholar
  93. 93.
    Campisi J. Aging and cancer cell biology, 2008. Aging Cell. 2008;7:281–4.PubMedGoogle Scholar
  94. 94.
    Shariat SF, Lotan Y, Karakiewicz PI, et al. p53 predictive value for pT1-2 N0 disease at radical cystectomy. J Urol. 2009;182:907–13.PubMedGoogle Scholar
  95. 95.
    Shariat SF, Karam JA, Lerner SP. Molecular markers in bladder cancer. Curr Opin Urol. 2008;18:1–8.PubMedGoogle Scholar
  96. 96.
    Wu XR. Urothelial tumorigenesis: a tale of divergent pathways. Nat Rev Cancer. 2005;5:713–25.PubMedGoogle Scholar
  97. 97.
    Shariat SF, Matsumoto K, Kim J, et al. Correlation of cyclooxygenase-2 expression with molecular markers, pathological features and clinical outcome of transitional cell carcinoma of the bladder. J Urol. 2003;170:985–9.PubMedGoogle Scholar
  98. 98.
    Shariat SF, Weizer AZ, Green A, et al. Prognostic value of P53 nuclear accumulation and histopathologic features in T1 transitional cell carcinoma of the urinary bladder. Urology. 2000;56:735–40.PubMedGoogle Scholar
  99. 99.
    Benson Jr RC, Tomera KM, Kelalis PP. Transitional cell carcinoma of the bladder in children and adolescents. J Urol. 1983;130:54–5.PubMedGoogle Scholar
  100. 100.
    Fitzpatrick JM, Reda M. Bladder carcinoma in patients 40 years old or less. J Urol. 1986;135:53–4.PubMedGoogle Scholar
  101. 101.
    Linn JF, Sesterhenn I, Mostofi FK, Schoenberg M. The molecular characteristics of bladder cancer in young patients. J Urol. 1998;159:1493–6.PubMedGoogle Scholar
  102. 102.
    Shariat SF. Selecting patients for immediate cystectomy. Rev Urol. 2007;9:239–41.PubMedCentralPubMedGoogle Scholar
  103. 103.
    Shariat SF, Pahlavan S, Baseman AG, et al. E-cadherin expression predicts clinical outcome in carcinoma in situ of the urinary bladder. Urology. 2001;57:60–5.PubMedGoogle Scholar
  104. 104.
    Chade DC, Shariat SF, Dalbagni G. Intravesical therapy for urothelial carcinoma of the urinary bladder: a critical review. Int Braz J Urol. 2009;35:640–50. discussion 51.PubMedGoogle Scholar
  105. 105.
    Sylvester RJ, van der Meijden AP. Intravesical bacillus Calmette-Guerin reduces the risk of progression in patients with superficial bladder cancer: a meta-analysis of the published results of randomized clinical trials. J Urol. 2002;168:1964–70.PubMedGoogle Scholar
  106. 106.
    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;178:2314–30.PubMedGoogle Scholar
  107. 107.
    Herr HW, Dotan Z, Donat SM, Bajorin DF. Defining optimal therapy for muscle invasive bladder cancer. J Urol. 2007;177:437–43.PubMedGoogle Scholar
  108. 108.
    Joudi FN, Dahmoush L, Spector DM, Konety BR. Complete response of bony metastatic bladder urothelial cancer to neoadjuvant chemotherapy and cystectomy. Urol Oncol. 2006;24:403–6.PubMedGoogle Scholar
  109. 109.
    Kohjimoto Y, Iba A, Shintani Y, Inagaki T, Uekado Y, Hara I. Impact of patient age on outcome following bladder-preserving treatment for non-muscle-invasive bladder cancer. World J Urol. 2010;28(4):425–30.PubMedGoogle Scholar
  110. 110.
    Heiner JG, Terris MK. Effect of advanced age on the development of complications from intravesical bacillus Calmette-Guerin therapy. Urol Oncol. 2008;26:137–40.PubMedGoogle Scholar
  111. 111.
    Grossman HB, Natale RB, Tangen CM, et al. Neoadjuvant chemotherapy plus cystectomy compared with cystectomy alone for locally advanced bladder cancer. N Engl J Med. 2003;349:859–66.PubMedGoogle Scholar
  112. 112.
    von der Maase H, Sengelov L, Roberts JT, et al. Long-term survival results of a randomized trial comparing gemcitabine plus cisplatin, with methotrexate, vinblastine, doxorubicin, plus cisplatin in patients with bladder cancer. J Clin Oncol. 2005;23:4602–8.PubMedGoogle Scholar
  113. 113.
    Advanced Bladder Cancer (ABC) Meta-analysis Collaboration. 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;48:202–5. discussion 5–6.Google Scholar
  114. 114.
    Advanced Bladder Cancer (ABC) Meta-analysis Collaboration. Adjuvant chemotherapy in invasive bladder cancer: a systematic review and meta-analysis of individual patient data Advanced Bladder Cancer (ABC) Meta-analysis Collaboration. Eur Urol. 2005;48:189–99. discussion 99–201.Google Scholar
  115. 115.
    Pectasides D, Pectasides M, Nikolaou M. Adjuvant and neoadjuvant chemotherapy in muscle invasive bladder cancer: literature review. Eur Urol. 2005;48:60–7. discussion 7–8.PubMedGoogle Scholar
  116. 116.
    Schultz PK, Herr HW, Zhang ZF, et al. Neoadjuvant chemotherapy for invasive bladder cancer: prognostic factors for survival of patients treated with M-VAC with 5-year follow-up. J Clin Oncol. 1994;12:1394–401.PubMedGoogle Scholar
  117. 117.
    Sonpavde G, Petrylak DP. Perioperative chemotherapy for bladder cancer. Crit Rev Oncol Hematol. 2006;57:133–44.PubMedGoogle Scholar
  118. 118.
    Prout Jr GR, Wesley MN, Yancik R, Ries LA, Havlik RJ, Edwards BK. Age and comorbidity impact surgical therapy in older bladder carcinoma patients: a population-based study. Cancer. 2005;104:1638–47.PubMedGoogle Scholar
  119. 119.
    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;64:292–7.PubMedGoogle Scholar
  120. 120.
    Gore JL, Litwin MS, Lai J, et al. Use of radical cystectomy for patients with invasive bladder cancer. J Natl Cancer Inst. 2010;102(11):802–11.PubMedCentralPubMedGoogle Scholar
  121. 121.
    Lodde M, Palermo S, Comploj E, et al. Four years experience in bladder preserving management for muscle invasive bladder cancer. Eur Urol. 2005;47:773–8. discussion 8–9.PubMedGoogle Scholar
  122. 122.
    Messing EM, editor. Urothelial tumors of the bladder. Philadelphia, PA: Saunders-Elsevier; 2008.Google Scholar
  123. 123.
    Fairey A, Chetner M, Metcalfe J, et al. Associations among age, comorbidity and clinical outcomes after radical cystectomy: results from the Alberta Urology Institute radical cystectomy database. J Urol. 2008;180:128–34. discussion 34.PubMedGoogle Scholar
  124. 124.
    Konety BR, Dhawan V, Allareddy V, Joslyn SA. Impact of hospital and surgeon volume on in-hospital mortality from radical cystectomy: data from the Health Care Utilization Project. J Urol. 2005;173:1695–700.PubMedGoogle Scholar
  125. 125.
    Hollenbeck BK, Miller DC, Taub D, et al. Identifying risk factors for potentially avoidable complications following radical cystectomy. J Urol. 2005;174:1231–7. discussion 1237.PubMedGoogle Scholar
  126. 126.
    Konety BR, Joslyn SA. Factors influencing aggressive therapy for bladder cancer: an analysis of data from the SEER program. J Urol. 2003;170:1765–71.PubMedGoogle Scholar
  127. 127.
    Clark PE, Stein JP, Groshen SG, et al. Radical cystectomy in the elderly: comparison of clinical outcomes between younger and older patients. Cancer. 2005;104:36–43.PubMedGoogle Scholar
  128. 128.
    Nielsen ME, Shariat SF, Karakiewicz PI, et al. Advanced age is associated with poorer bladder cancer-specific survival in patients treated with radical cystectomy. Eur Urol. 2007;51:699–706. discussion −8.PubMedGoogle Scholar
  129. 129.
    Prout GR, Marshall VF. The prognosis with untreated bladder tumors. Cancer. 1956;9:551–8.PubMedGoogle Scholar
  130. 130.
    Rosario DJ, Becker M, Anderson JB. The changing pattern of mortality and morbidity from radical cystectomy. BJU Int. 2000;85:427–30.PubMedGoogle Scholar
  131. 131.
    Shabsigh A, Korets R, Vora KC, et al. Defining early morbidity of radical cystectomy for patients with bladder cancer using a standardized reporting methodology. Eur Urol. 2009;55:164–74.PubMedGoogle Scholar
  132. 132.
    Shabsigh A, Korets R, Vora KC, et al. Defining early morbidity of radical cystectomy for patients with bladder cancer using a standardized reporting methodology. Eur Urol. 2008;55(1):164–74.PubMedGoogle Scholar
  133. 133.
    Donat SM, Shabsigh A, Savage C, et al. Potential impact of postoperative early complications on the timing of adjuvant chemotherapy in patients undergoing radical cystectomy: a high-volume tertiary cancer center experience. Eur Urol. 2009;55:177–85.PubMedGoogle Scholar
  134. 134.
    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.PubMedGoogle Scholar
  135. 135.
    Farnham SB, Cookson MS, Alberts G, Smith Jr JA, Chang SS. Benefit of radical cystectomy in the elderly patient with significant co-morbidities. Urol Oncol. 2004;22:178–81.PubMedGoogle Scholar
  136. 136.
    Bostrom PJ, Kossi J, Laato M, Nurmi M. Risk factors for mortality and morbidity related to radical cystectomy. BJU Int. 2009;103:191–6.PubMedGoogle Scholar
  137. 137.
    Zebic N, Weinknecht S, Kroepfl D. Radical cystectomy in patients aged > or = 75 years: an updated review of patients treated with curative and palliative intent. BJU Int. 2005;95:1211–4.PubMedGoogle Scholar
  138. 138.
    Mendiola FP, Zorn KC, Gofrit ON, et al. Cystectomy in the ninth decade: operative results and long-term survival outcomes. Can J Urol. 2007;14:3628–34.PubMedGoogle Scholar
  139. 139.
    Knap MM, Lundbeck F, Overgaard J. Early and late treatment-related morbidity following radical cystectomy. Scand J Urol Nephrol. 2004;38:153–60.PubMedGoogle Scholar
  140. 140.
    Elting LS, Pettaway C, Bekele BN, et al. Correlation between annual volume of cystectomy, professional staffing, and outcomes: a statewide, population-based study. Cancer. 2005;104:975–84.PubMedGoogle Scholar
  141. 141.
    Yamanaka K, Miyake H, Hara I, Inoue TA, Fujisawa M. Significance of radical cystectomy for bladder cancer in patients over 80 years old. Int Urol Nephrol. 2007;39:209–14.PubMedGoogle Scholar
  142. 142.
    Chang SS, Jacobs B, Wells N, Smith Jr JA, Cookson MS. Increased body mass index predicts increased blood loss during radical cystectomy. J Urol. 2004;171:1077–9.PubMedGoogle Scholar
  143. 143.
    Lowrance WT, Rumohr JA, Chang SS, Clark PE, Smith Jr JA, Cookson MS. Contemporary open radical cystectomy: analysis of perioperative outcomes. J Urol. 2008;179:1313–8. discussion 8.PubMedGoogle Scholar
  144. 144.
    Cardenas-Turanzas M, Cooksley C, Kamat AM, Pettaway CA, Elting LS. Gender and age differences in blood utilization and length of stay in radical cystectomy: a population-based study. Int Urol Nephrol. 2008;40:893–9.PubMedGoogle Scholar
  145. 145.
    Stroumbakis N, Herr HW, Cookson MS, Fair WR. Radical cystectomy in the octogenarian. J Urol. 1997;158:2113–7.PubMedGoogle Scholar
  146. 146.
    Madersbacher S, Mohrle K, Burkhard F, Studer UE. Long-term voiding pattern of patients with ileal orthotopic bladder substitutes. J Urol. 2002;167:2052–7.PubMedGoogle Scholar
  147. 147.
    Hautmann RE, Miller K, Steiner U, Wenderoth U. The ileal neobladder: 6 years of experience with more than 200 patients. J Urol. 1993;150:40–5.PubMedGoogle Scholar
  148. 148.
    Kessler TM, Burkhard FC, Perimenis P, et al. Attempted nerve sparing surgery and age have a significant effect on urinary continence and erectile function after radical cystoprostatectomy and ileal orthotopic bladder substitution. J Urol. 2004;172:1323–7.PubMedGoogle Scholar
  149. 149.
    Sogni F, Brausi M, Frea B, et al. Morbidity and quality of life in elderly patients receiving ileal conduit or orthotopic neobladder after radical cystectomy for invasive bladder cancer. Urology. 2008;71:919–23.PubMedGoogle Scholar
  150. 150.
    Hugonnet CL, Danuser H, Springer JP, Studer UE. Decreased sensitivity in the membranous urethra after orthotopic ileal bladder substitute. J Urol. 1999;161:418–21.PubMedGoogle Scholar
  151. 151.
    Cohen HJ. The cancer aging interface: a research agenda. J Clin Oncol. 2007;25:1945–8.PubMedGoogle Scholar
  152. 152.
    Lichtman SM, Wildiers H, Chatelut E, et al. International Society of Geriatric Oncology Chemotherapy Taskforce: evaluation of chemotherapy in older patients–an analysis of the medical literature. J Clin Oncol. 2007;25:1832–43.PubMedGoogle Scholar
  153. 153.
    Surbone A, Kagawa-Singer M, Terret C, Baider L. The illness trajectory of elderly cancer patients across cultures: SIOG position paper. Ann Oncol. 2007;18:633–8.PubMedGoogle Scholar
  154. 154.
    Terret C, Zulian G, Droz JP. Statements on the interdependence between the oncologist and the geriatrician in geriatric oncology. Crit Rev Oncol Hematol. 2004;52:127–33.PubMedGoogle Scholar
  155. 155.
    Lichtman SM, Boparai MK. Anticancer drug therapy in the older cancer patient: pharmacology and polypharmacy. Curr Treat Options Oncol. 2008;9:191–203.PubMedGoogle Scholar
  156. 156.
    Li SH, Chen WH, Tang Y, et al. Incidence of ischemic stroke post-chemotherapy: a retrospective review of 10,963 patients. Clin Neurol Neurosurg. 2006;108:150–6.PubMedGoogle Scholar
  157. 157.
    Dash A, Pettus 4th JA, Herr HW, et al. A role for neoadjuvant gemcitabine plus cisplatin in muscle-invasive urothelial carcinoma of the bladder: a retrospective experience. Cancer. 2008;113:2471–7.PubMedCentralPubMedGoogle Scholar
  158. 158.
    Langer CJ, Manola J, Bernardo P, et al. Cisplatin-based therapy for elderly patients with advanced non-small-cell lung cancer: implications of Eastern Cooperative Oncology Group 5592, a randomized trial. J Natl Cancer Inst. 2002;94:173–81.PubMedGoogle Scholar
  159. 159.
    Castagneto B, Zai S, Marenco D, et al. Single-agent gemcitabine in previously untreated elderly patients with advanced bladder carcinoma: response to treatment and correlation with the comprehensive geriatric assessment. Oncology. 2004;67:27–32.PubMedGoogle Scholar
  160. 160.
    Bamias A, Lainakis G, Kastritis E, et al. Biweekly carboplatin/gemcitabine in patients with advanced urothelial cancer who are unfit for cisplatin-based chemotherapy: report of efficacy, quality of life and geriatric assessment. Oncology. 2007;73:290–7.PubMedGoogle Scholar
  161. 161.
    James D, Hussain S, Hall E, et al. Results of a phase III randomized trial of synchronous chemoradiotherapy (CRT) compared to radiotherapy (RT) alone in muscle-invasive bladder cancer (MIBC). J Clin Oncol. 2010;28:15s (suppl; abstr 4517).Google Scholar
  162. 162.
    Kemeny MM. Surgery in older patients. Semin Oncol. 2004;31:175–84.PubMedGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  • Daniel J. Lee
    • 1
  • Shahrokh Shariat
    • 2
  • Jeffrey M. Holzbeierlein
    • 3
    Email author
  1. 1.Department of UrologyUniversity of Iowa HospitalsIowa CityUSA
  2. 2.Department of UrologyWeill Cornell Medical CollegeNew YorkUSA
  3. 3.Department of UrologyThe University of Kansas HopsitalKansas CityUSA

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