Does patient age affect survival after radical cystectomy?

David Horovitz, Polat Turker, Peter J. Bostrom, Tuomas Mirtti, Martti Nurmi, Cynthia Kuk, Girish Kulkarni, Neil E. Fleshner, Antonio Finelli, Michael A. Jewett, Alexandre R. Zlotta

Tutkimustuotos: ArtikkelijulkaisuArtikkeliTieteellinenvertaisarvioitu

Kuvaus

Objective: To analyze the impact of patient age on survival after radical
cystectomy (RC).
Patients and Methods: Advanced age is a known risk factor for the
development of bladder cancer (BC) and with the increased longevity seen
in the population, urologists now treat an increasing number of senior
patients with this disease. Two ethics approved databases of BC patients
undergoing RC at University Heath Network, Toronto, Canada (1992-2008)
and University of Turku, Turku, Finland (1986-2005) were retrospectively
analysed. Six hundred and five patients who underwent this procedure
between June 1985 and March 2010 were included. Patients were
categorically divided into four age groups: ≤59, 60-69, 70-79,
≥80. Demographic, clinical and pathological data were compared, as well
as recurrence-free survival (RFS), disease-specific survival (DSS) and
overall survival (OAS).
Results: Compared to younger patients (age ≤79 years), elderly patients
(age ≥80 years) had higher ASA scores (p<0.0001), a greater number of
lymph nodes removed during surgical dissection (p=0.0005), and they
underwent less adjuvant treatment (p<0.0001). Choice of urinary
diversion differed between groups with ileal conduit being used for all
patients ≥80 years (p<0.0001). No differences were noted between age
groups with respect to RFS (p=0.3), DSS (p=0.4) or OAS (p=0.4).
Conclusion: Although RC is an operation with significant morbidity, it is a
viable treatment option for carefully selected elderly patients. Senior
patients (≥80 years) should not be denied RC if they are deemed fit to
undergo surgery. Senior adults do not suffer from adverse
histopathological features as compared to younger patients either.

Alkuperäiskielienglanti
LehtiBJU International
Vuosikerta110
Numero11B
SivutE486-E493
Sivumäärä8
ISSN1464-4096
DOI - pysyväislinkit
TilaJulkaistu - joulukuuta 2012
OKM-julkaisutyyppiA1 Alkuperäisartikkeli tieteellisessä aikakauslehdessä, vertaisarvioitu

Tieteenalat

  • 3121 Sisätaudit
  • 3126 Kirurgia, anestesiologia, tehohoito, radiologia

Lainaa tätä

Horovitz, D., Turker, P., Bostrom, P. J., Mirtti, T., Nurmi, M., Kuk, C., ... Zlotta, A. R. (2012). Does patient age affect survival after radical cystectomy? BJU International, 110(11B), E486-E493. https://doi.org/10.1111/j.1464-410X.2012.11180.x
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. / Does patient age affect survival after radical cystectomy?. Julkaisussa: BJU International. 2012 ; Vuosikerta 110, Nro 11B. Sivut E486-E493.
@article{199a85c0270b4cbda17d3935ac27e77e,
title = "Does patient age affect survival after radical cystectomy?",
abstract = "Objective: To analyze the impact of patient age on survival after radicalcystectomy (RC).Patients and Methods: Advanced age is a known risk factor for thedevelopment of bladder cancer (BC) and with the increased longevity seenin the population, urologists now treat an increasing number of seniorpatients with this disease. Two ethics approved databases of BC patientsundergoing RC at University Heath Network, Toronto, Canada (1992-2008)and University of Turku, Turku, Finland (1986-2005) were retrospectivelyanalysed. Six hundred and five patients who underwent this procedurebetween June 1985 and March 2010 were included. Patients werecategorically divided into four age groups: ≤59, 60-69, 70-79,≥80. Demographic, clinical and pathological data were compared, as wellas recurrence-free survival (RFS), disease-specific survival (DSS) andoverall survival (OAS).Results: Compared to younger patients (age ≤79 years), elderly patients(age ≥80 years) had higher ASA scores (p<0.0001), a greater number oflymph nodes removed during surgical dissection (p=0.0005), and theyunderwent less adjuvant treatment (p<0.0001). Choice of urinarydiversion differed between groups with ileal conduit being used for allpatients ≥80 years (p<0.0001). No differences were noted between agegroups with respect to RFS (p=0.3), DSS (p=0.4) or OAS (p=0.4).Conclusion: Although RC is an operation with significant morbidity, it is aviable treatment option for carefully selected elderly patients. Seniorpatients (≥80 years) should not be denied RC if they are deemed fit toundergo surgery. Senior adults do not suffer from adversehistopathological features as compared to younger patients either.",
keywords = "bladder cancer, radical cystectomy, age, elderly, INVASIVE BLADDER-CANCER, ELDERLY-PATIENTS, OLDER PATIENTS, CARCINOMA, COMORBIDITY, OUTCOMES, SURGERY, PROSTATECTOMY, POPULATION, THERAPY, 3121 Internal medicine, 3126 Surgery, anesthesiology, intensive care, radiology",
author = "David Horovitz and Polat Turker and Bostrom, {Peter J.} and Tuomas Mirtti and Martti Nurmi and Cynthia Kuk and Girish Kulkarni and Fleshner, {Neil E.} and Antonio Finelli and Jewett, {Michael A.} and Zlotta, {Alexandre R.}",
year = "2012",
month = "12",
doi = "10.1111/j.1464-410X.2012.11180.x",
language = "English",
volume = "110",
pages = "E486--E493",
journal = "BJU International",
issn = "1464-4096",
publisher = "Wiley",
number = "11B",

}

Horovitz, D, Turker, P, Bostrom, PJ, Mirtti, T, Nurmi, M, Kuk, C, Kulkarni, G, Fleshner, NE, Finelli, A, Jewett, MA & Zlotta, AR 2012, 'Does patient age affect survival after radical cystectomy?' BJU International, Vuosikerta 110, Nro 11B, Sivut E486-E493. https://doi.org/10.1111/j.1464-410X.2012.11180.x

Does patient age affect survival after radical cystectomy? / 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.

julkaisussa: BJU International, Vuosikerta 110, Nro 11B, 12.2012, s. E486-E493.

Tutkimustuotos: ArtikkelijulkaisuArtikkeliTieteellinenvertaisarvioitu

TY - JOUR

T1 - Does patient age affect survival after radical cystectomy?

AU - Horovitz, David

AU - Turker, Polat

AU - Bostrom, Peter J.

AU - Mirtti, Tuomas

AU - Nurmi, Martti

AU - Kuk, Cynthia

AU - Kulkarni, Girish

AU - Fleshner, Neil E.

AU - Finelli, Antonio

AU - Jewett, Michael A.

AU - Zlotta, Alexandre R.

PY - 2012/12

Y1 - 2012/12

N2 - Objective: To analyze the impact of patient age on survival after radicalcystectomy (RC).Patients and Methods: Advanced age is a known risk factor for thedevelopment of bladder cancer (BC) and with the increased longevity seenin the population, urologists now treat an increasing number of seniorpatients with this disease. Two ethics approved databases of BC patientsundergoing RC at University Heath Network, Toronto, Canada (1992-2008)and University of Turku, Turku, Finland (1986-2005) were retrospectivelyanalysed. Six hundred and five patients who underwent this procedurebetween June 1985 and March 2010 were included. Patients werecategorically divided into four age groups: ≤59, 60-69, 70-79,≥80. Demographic, clinical and pathological data were compared, as wellas recurrence-free survival (RFS), disease-specific survival (DSS) andoverall survival (OAS).Results: Compared to younger patients (age ≤79 years), elderly patients(age ≥80 years) had higher ASA scores (p<0.0001), a greater number oflymph nodes removed during surgical dissection (p=0.0005), and theyunderwent less adjuvant treatment (p<0.0001). Choice of urinarydiversion differed between groups with ileal conduit being used for allpatients ≥80 years (p<0.0001). No differences were noted between agegroups with respect to RFS (p=0.3), DSS (p=0.4) or OAS (p=0.4).Conclusion: Although RC is an operation with significant morbidity, it is aviable treatment option for carefully selected elderly patients. Seniorpatients (≥80 years) should not be denied RC if they are deemed fit toundergo surgery. Senior adults do not suffer from adversehistopathological features as compared to younger patients either.

AB - Objective: To analyze the impact of patient age on survival after radicalcystectomy (RC).Patients and Methods: Advanced age is a known risk factor for thedevelopment of bladder cancer (BC) and with the increased longevity seenin the population, urologists now treat an increasing number of seniorpatients with this disease. Two ethics approved databases of BC patientsundergoing RC at University Heath Network, Toronto, Canada (1992-2008)and University of Turku, Turku, Finland (1986-2005) were retrospectivelyanalysed. Six hundred and five patients who underwent this procedurebetween June 1985 and March 2010 were included. Patients werecategorically divided into four age groups: ≤59, 60-69, 70-79,≥80. Demographic, clinical and pathological data were compared, as wellas recurrence-free survival (RFS), disease-specific survival (DSS) andoverall survival (OAS).Results: Compared to younger patients (age ≤79 years), elderly patients(age ≥80 years) had higher ASA scores (p<0.0001), a greater number oflymph nodes removed during surgical dissection (p=0.0005), and theyunderwent less adjuvant treatment (p<0.0001). Choice of urinarydiversion differed between groups with ileal conduit being used for allpatients ≥80 years (p<0.0001). No differences were noted between agegroups with respect to RFS (p=0.3), DSS (p=0.4) or OAS (p=0.4).Conclusion: Although RC is an operation with significant morbidity, it is aviable treatment option for carefully selected elderly patients. Seniorpatients (≥80 years) should not be denied RC if they are deemed fit toundergo surgery. Senior adults do not suffer from adversehistopathological features as compared to younger patients either.

KW - bladder cancer

KW - radical cystectomy

KW - age

KW - elderly

KW - INVASIVE BLADDER-CANCER

KW - ELDERLY-PATIENTS

KW - OLDER PATIENTS

KW - CARCINOMA

KW - COMORBIDITY

KW - OUTCOMES

KW - SURGERY

KW - PROSTATECTOMY

KW - POPULATION

KW - THERAPY

KW - 3121 Internal medicine

KW - 3126 Surgery, anesthesiology, intensive care, radiology

U2 - 10.1111/j.1464-410X.2012.11180.x

DO - 10.1111/j.1464-410X.2012.11180.x

M3 - Article

VL - 110

SP - E486-E493

JO - BJU International

JF - BJU International

SN - 1464-4096

IS - 11B

ER -

Horovitz D, Turker P, Bostrom PJ, Mirtti T, Nurmi M, Kuk C et al. Does patient age affect survival after radical cystectomy? BJU International. 2012 joulu;110(11B):E486-E493. https://doi.org/10.1111/j.1464-410X.2012.11180.x