Comparison of Radical Cystectomy with Conservative Treatment in Geriatric ( 80) Patients with Muscle-Invasive Bladder Cancer
Introduction The aim of this study was to compare overall survival in elderly patients (≥ 80 years) with muscle-invasive bladder cancer (MIBC) undergoing either radical cystectomy (RC) or conservative treatment. Material and Methods We performed a retrospective, comparative analysis of overall- and...
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| Format: | Article |
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Sociedade Brasileira de Urologia
2013-09-01
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| Series: | International Brazilian Journal of Urology |
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| Online Access: | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1677-55382013000500622&lng=en&tlng=en |
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| author | Thomas Martini Roman Mayr Clemens Wehrberger Christopher Dechet Michele Lodde Salvatore Palermo Emanuela Trenti Evi Comploj Armin Pycha |
| author_facet | Thomas Martini Roman Mayr Clemens Wehrberger Christopher Dechet Michele Lodde Salvatore Palermo Emanuela Trenti Evi Comploj Armin Pycha |
| author_sort | Thomas Martini |
| collection | DOAJ |
| description | Introduction The aim of this study was to compare overall survival in elderly patients (≥ 80 years) with muscle-invasive bladder cancer (MIBC) undergoing either radical cystectomy (RC) or conservative treatment. Material and Methods We performed a retrospective, comparative analysis of overall- and cancer-specific survival in octagenarians with MIBC (≥ pT2) submitted to RC or conservative treatment. Uni- and multivariable Cox regression analysis were performed to assess predictors of overall survival. Cumulative hospital stay was also analyzed for all patients. Results The RC-group consisted of 33 patients with a mean age of 82.3 years (IQR 80.4-85.4 years) and the bladder preservation a cohort of 35 patients aged 83.8 years (IQR 81.8-88.2 years). No difference was detectable for overall survival (15.9 months versus 9.5 months; p = 0.18) and cancer-specific survival (23.5 months versus 19.5 months p = 0.71) or 90-day mortality (6.1% versus 14.3%; p = 0.43) between the two groups. Patients who received conservative treatment had a shorter cumulative length of hospital stay (p = 0.001). Age at the time of transurethral resection of the bladder (TUR-B) was an independent predictor of the overall survival (p = 0.004). Conclusions In this retrospective study, no clear survival benefit was observed for patients ≥ 80 years submitted either to radical cystectomy or conservative treatment. There was however a trend favoring radical cystectomy but this did not approach statistical significance. Octagenarians that underwent RC however spent more of their remaining lifetime in the hospital than those treated conservatively. |
| first_indexed | 2024-12-23T05:09:45Z |
| format | Article |
| id | doaj.art-bad46c14745a42eb9f85d5957ac7b20b |
| institution | Directory Open Access Journal |
| issn | 1677-6119 |
| language | English |
| last_indexed | 2024-12-23T05:09:45Z |
| publishDate | 2013-09-01 |
| publisher | Sociedade Brasileira de Urologia |
| record_format | Article |
| series | International Brazilian Journal of Urology |
| spelling | doaj.art-bad46c14745a42eb9f85d5957ac7b20b2022-12-21T17:59:00ZengSociedade Brasileira de UrologiaInternational Brazilian Journal of Urology1677-61192013-09-0139562263010.1590/S1677-5538.IBJU.2013.05.03S1677-55382013000500622Comparison of Radical Cystectomy with Conservative Treatment in Geriatric ( 80) Patients with Muscle-Invasive Bladder CancerThomas MartiniRoman MayrClemens WehrbergerChristopher DechetMichele LoddeSalvatore PalermoEmanuela TrentiEvi ComplojArmin PychaIntroduction The aim of this study was to compare overall survival in elderly patients (≥ 80 years) with muscle-invasive bladder cancer (MIBC) undergoing either radical cystectomy (RC) or conservative treatment. Material and Methods We performed a retrospective, comparative analysis of overall- and cancer-specific survival in octagenarians with MIBC (≥ pT2) submitted to RC or conservative treatment. Uni- and multivariable Cox regression analysis were performed to assess predictors of overall survival. Cumulative hospital stay was also analyzed for all patients. Results The RC-group consisted of 33 patients with a mean age of 82.3 years (IQR 80.4-85.4 years) and the bladder preservation a cohort of 35 patients aged 83.8 years (IQR 81.8-88.2 years). No difference was detectable for overall survival (15.9 months versus 9.5 months; p = 0.18) and cancer-specific survival (23.5 months versus 19.5 months p = 0.71) or 90-day mortality (6.1% versus 14.3%; p = 0.43) between the two groups. Patients who received conservative treatment had a shorter cumulative length of hospital stay (p = 0.001). Age at the time of transurethral resection of the bladder (TUR-B) was an independent predictor of the overall survival (p = 0.004). Conclusions In this retrospective study, no clear survival benefit was observed for patients ≥ 80 years submitted either to radical cystectomy or conservative treatment. There was however a trend favoring radical cystectomy but this did not approach statistical significance. Octagenarians that underwent RC however spent more of their remaining lifetime in the hospital than those treated conservatively.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1677-55382013000500622&lng=en&tlng=enCystectomyUrinary BladderAged, 80 and overHospitalsTherapeutics |
| spellingShingle | Thomas Martini Roman Mayr Clemens Wehrberger Christopher Dechet Michele Lodde Salvatore Palermo Emanuela Trenti Evi Comploj Armin Pycha Comparison of Radical Cystectomy with Conservative Treatment in Geriatric ( 80) Patients with Muscle-Invasive Bladder Cancer International Brazilian Journal of Urology Cystectomy Urinary Bladder Aged, 80 and over Hospitals Therapeutics |
| title | Comparison of Radical Cystectomy with Conservative Treatment in Geriatric ( 80) Patients with Muscle-Invasive Bladder Cancer |
| title_full | Comparison of Radical Cystectomy with Conservative Treatment in Geriatric ( 80) Patients with Muscle-Invasive Bladder Cancer |
| title_fullStr | Comparison of Radical Cystectomy with Conservative Treatment in Geriatric ( 80) Patients with Muscle-Invasive Bladder Cancer |
| title_full_unstemmed | Comparison of Radical Cystectomy with Conservative Treatment in Geriatric ( 80) Patients with Muscle-Invasive Bladder Cancer |
| title_short | Comparison of Radical Cystectomy with Conservative Treatment in Geriatric ( 80) Patients with Muscle-Invasive Bladder Cancer |
| title_sort | comparison of radical cystectomy with conservative treatment in geriatric 80 patients with muscle invasive bladder cancer |
| topic | Cystectomy Urinary Bladder Aged, 80 and over Hospitals Therapeutics |
| url | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1677-55382013000500622&lng=en&tlng=en |
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