Abstract
Introduction: Clinical results of radical cystectomy performed on elderly bladder cancer patients over 70 years old were assessed to determine whether age is one of the critical points for the application of this type of surgery. Materials: From January 1992 to December 2002, 41 radical cystectomy performed in septuagenarian population were compared with 197 performed in patients less than 70 years of age. Results: The early and late complication rate for septuagenarians was 29.7% and 12%, compared with 26.9% and 9.6% for patients younger than 70 years respectively. The overall mortality rate for septuagenarians was 4.9%, compared with 8.6% for patients younger than 70 years. There was no significant difference between the two groups with regard to pathologic stage or length of hospital stay. The 5-year overall survival rate for septuagenarians was 53% compared with 59% for patients younger than 70 years. Conclusions: When indicated after adequate preoperative assessment and optimization of the patient, radical cystectomy is a safe procedure in the septuagenarians and patient should not be denied surgery dependent on chronologic age.
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P. Rischmann H. Bittard DK. Chopkin et al. (1998) ArticleTitleRecommandations du Comité de Cancérlogie de 1’Association Francaise d’Urologie Tumerus urotheliales. Progr Urol. 8 25
M. Tachibana N. Deguchi S. Jitsukawa et al. (1983) ArticleTitleOne stage total cystectomy and ileal loop diversion in patients over 80Â years’ old with bladder carcinoma: pre- and post-operative functional reserve of various organs Urology. 22 512–516
WF. Hendry (1986) ArticleTitleMorbidity and mortality of radical cystectomy (1971–78 and 1978–85) J R soc Med. 79 395
JE. Montie DP. Wood SuffixJr. (1989) ArticleTitleThe risk of radical cystectomy Br J Urol. 63 483
JW. Sullivan JE. Montie (1997) ArticleTitleSummary of complications of ureteroileal conduit with radical cystectomy: review of 336 cases Semin Urol Oncol. 15 94
S. Holmang G. Borghede (1996) ArticleTitleEarly complications and survival following short-term palliative radiotherapy in invasive bladder carcinoma J Urol. 155 100
JE. Montie (1999) ArticleTitleAgainst bladder sparing surgery J Urol. 162 452
SS. Chang G. Alberts MS. Cookson et al. (2001) ArticleTitleRadical cystectomy is safe elderly at high risk J Urol. 166 938
AJ. Figueroa JP. stein M. Dickinson et al. (1998) ArticleTitleRadical cystectomy for elderly patients with bladder carcinoma. An update experience with 404 patients Cancer 83 141 Occurrence Handle10.1002/(SICI)1097-0142(19980701)83:1<141::AID-CNCR19>3.0.CO;2-X Occurrence Handle9655304
EC. Skinner G. Lieskovsky DG. Skinner (1984) ArticleTitleRadical cystectomy in the elderly patient J Urol. 131 1065
AS. Keats (1978) ArticleTitleThe ASA classification of physical status A recapitulation Anesthesiology. 49 233
JR. Drago TJ. Rohner SuffixJr. (1983) ArticleTitleCystectomy and urinary diversion: a safe procedure for elderly patients Urology. 21 17–19
DP. Wood JE. Montie SuffixJr. TI. Maatman GJ. Beck (1987) ArticleTitleRadical cystectomy for carcinoma of the bladder in the elderly patient J Urol. 138 46–48
I. Leibovitch I. Avigad J. Ben-Chaim et al. (1993) ArticleTitleIs it justified to avoid radical cystoprostatectomy in elderly patients with invasive transitional cell carcinoma of the bladder? Cancer. 71 3098–3101
EJ. Zingg B. Bornet MC. Bishop (1980) ArticleTitleUrinary diversion in the elderly patient Eur Urol. 6 347–351
N. Stroumbakis HW. Herr MS. Cookson WR. Fair (1997) ArticleTitleRadical cystectomy in the octogenarian J Urol. 158 2113–2117
HA. Frazier JE. Robertson DF. Paulson (1992) ArticleTitleComplications of radical cystectomy and urinary diversion: a retrospective review of 675 cases in 2 decades J Urol. 148 1401
JP. Stein G. Lieskovsky R. Cote et al. (2001) ArticleTitleRadical cystectomy in the treatment of invasive bladder cancer: long term results in 1054 patients J Clin Oncol. 19 666
RD. Brandsteller H. Kazemi (1983) ArticleTitleAging and the respiratory system Med Clin North Am. 67 419
JD. Schor SE. Levkoff LA. Lipsitz et al. (1992) ArticleTitleRisk factors for delirium in hospitalized elderly JAMA. 267 827
R. Roca (1994) ArticleTitlePsychosocial aspects of surgical in the elderly patients Surg Clin North Am. 74 223
T. Pederson K. Eliasen M. Ravnborg et al. (1986) ArticleTitleRisk factors, complications and outcome in anaesthesia A pilot study. Eur J Anaesthesiol. 3 225
U. Wolters T. Wolf H. Stutzer et al. (1996) ArticleTitleASA classification and perioperative variables as predictors of postoperative outcome Br J Anaesth. 77 217
M. Soulie M. Straub X. Game et al. (2002) ArticleTitleA multicenter study of the morbidity of radical cystectomy in select elderly patients with bladder cancer J Urol. 167 1325–1328
DM. Thomas PR. Riddle (1982) ArticleTitleMorbidity and mortality in 100 cosecutive radical cystectomies Brit J Urol. 54 716
RS. Lance HB. Grossman (2001) ArticleTitleCystectomy in the elderly Semin Urol Oncol. 19 51
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Gupta, N.P., Goel, R., Hemal, A.K. et al. Radical cystectomy in septuagenarian patients with bladder cancer. Int Urol Nephrol 36, 353–358 (2004). https://doi.org/10.1007/s11255-004-0913-2
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DOI: https://doi.org/10.1007/s11255-004-0913-2