Does patient age affect survival after radical cystectomy?

作者：Horovitz David; Turker Polat^*; Bostrom Peter J; Mirtti Tuomas; Nurmi Martti; Kuk Cynthia; Kulkarni Girish; Fleshner Neil E; Finelli Antonio; Jewett Michael A; Zlotta Alexandre R

来源：BJU International, 2012, 110(11B): E486-E493.

DOI：10.1111/j.1464-410X.2012.11180.x

• bladder cancer
• radical cystectomy
• age
• elderly

OBJECTIVE %26lt;br%26gt;To analyse the impact of patient age on survival after radical cystectomy (RC). %26lt;br%26gt;PATIENTS AND METHODS %26lt;br%26gt;After ethics review board approval, two databases of patients with bladder cancer (BC) undergoing RC at the University Heath Network, Toronto, Canada (1992-2008) and the University of Turku, Turku, Finland (1986-2005) were retrospectively analysed. %26lt;br%26gt;A total of 605 patients who underwent this procedure between June 1985 and March 2010 were included. %26lt;br%26gt;Patients were divided into four age groups: %26lt;= 59, 60-69, 70-79 and %26gt;= 80 years. %26lt;br%26gt;Demographic, clinical and pathological data were compared, as well as recurrence-free survival (RFS), disease-specific survival (DSS) and overall survival (OAS) rates. %26lt;br%26gt;RESULTS %26lt;br%26gt;Compared with younger patients (age %26lt;= 79 years), elderly patients (age %26gt;= 80 years) had higher American Society of Anesthesiologists scores (P %26lt; 0.001), a greater number of lymph nodes removed during surgical dissection (P %26lt; 0.001), and underwent less adjuvant treatment (P %26lt; 0.001). %26lt;br%26gt;Choice of urinary diversion differed among the groups, with ileal conduit being used for all patients %26gt;= 80 years (P %26lt; 0.001). %26lt;br%26gt;No differences were noted between age groups with respect to RFS (P = 0.3), DSS (P = 0.4) or OAS (P = 0.4). %26lt;br%26gt;CONCLUSION %26lt;br%26gt;Although RC is an operation with significant morbidity, it is a viable treatment option for carefully selected elderly patients. Senior patients (%26gt;= 80 years) should not be denied RC if they are deemed fit to undergo surgery. %26lt;br%26gt;Senior adults do not suffer from adverse histopathological features as compared with younger patients.

• 出版日期2012-12