Radical cystectomy and perioperative chemotherapy in octogenarians with bladder cancer

Authors

  • Ziv Savin Sourasky medical Center, Tel Aviv
  • Haim Hertzberg Tel Aviv Sourasky Medical Center
  • Eran Schreter Tel Aviv Sourasky Medical Center
  • Reuben Ben David Tel Aviv Sourasky Medical Center
  • Yuval Bar-Yosef Tel Aviv Sourasky Medical Center
  • Mario Sofer Tel Aviv Sourasky Medical Center
  • Avi Beri Tel Aviv Sourasky Medical Center
  • Ofer Yossepowitch Tel Aviv Sourasky Medical Center
  • Roy Mano Tel Aviv Sourasky Medical Center

DOI:

https://doi.org/10.5489/cuaj.6907

Keywords:

Bladder cancer, Radical cystectomy, Octogenarians, Perioperative morbidity, Perioperative chemotherapy

Abstract

Introduction: We aimed to compare the treatment patterns and oncological outcomes, including postoperative morbidity and chemotherapy use, between octogenarians and patients <80 years of age who underwent radical cystectomy for bladder cancer.

Methods: We conducted a retrospective analysis of 119 patients who underwent radical cystectomy for bladder cancer at our center between January 2013 and April 2019. Comorbidities, clinical and pathological data, 30-day postoperative morbidity, and perioperative chemotherapy use were compared between octogenarians (n=31) and younger patients (n=88). Cancer-specific and overall survival rates were estimated with the Kaplan-Meier method and compared between the groups.

Results: No significant differences were found between the age groups in the clinical and pathological findings, including Charlson comorbidity index, modified frailty index, albumin level, renal function, and TNM stage. The median followup for survivors was 19 months (interquartile range [IQR] 11–30). Major complications (Clavien-Dindo grade ≥3) and 30-day postoperative mortality rates did not differ between the age groups (p=0.3 and p=0.18, respectively). Despite no difference in baseline glomerular filtration rates, perioperative chemotherapy utilization rate was lower among octogenarians compared to younger patients (13% vs. 34%, p=0.03). Estimated two-year cancer-specific survival rates for octogenerians and younger patients were 40% and 75%, respectively. Similarly, estimated two-year overall survival rates were 30% and 69%, respectively. Both cancer-specific and overall survival rates were significantly lower in octogenarians (p=0.007 and p=0.001, respectively).

Conclusions: Radical cystectomy in octogenarians results in comparable short-term outcomes as in younger patients. However, in the elderly population, perioperative chemotherapy utilization rates are lower and survival is inferior.

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Published

2021-02-12 — Updated on 2021-09-10

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How to Cite

Savin, Z., Hertzberg, H., Schreter, E., Ben David, R., Bar-Yosef, Y., Sofer, M., Beri, A., Yossepowitch, O., & Mano, R. (2021). Radical cystectomy and perioperative chemotherapy in octogenarians with bladder cancer. Canadian Urological Association Journal, 15(9), E465–70. https://doi.org/10.5489/cuaj.6907 (Original work published February 12, 2021)

Issue

Vol. 15 No. 9 (2021): CUAJ September

Section

Original Research

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