Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
SHR Neuro Krebs Kardio Lipid Stoffw Microb
Chromecki, TF; Mauermann, J; Cha, EK; Svatek, RS; Fajkovic, H; Karakiewicz, PI; Lotan, Y; Tilki, D; Bastian, PJ; Volkmer, BG; Montorsi, F; Kassouf, W; Novara, G; Fritsche, HM; Ficarra, V; Stief, CG; Dinney, CP; Skinner, E; Pummer, K; Fradet, Y; Shariat, SF.
Multicenter validation of the prognostic value of patient age in patients treated with radical cystectomy.
World J Urol. 2012; 30(6):753-759
Doi: 10.1007/s00345-011-0772-2
Web of Science
PubMed
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- Führende Autor*innen der Med Uni Graz
- Chromecki Thomas
- Co-Autor*innen der Med Uni Graz
- Pummer Karl
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- Abstract:
- Small studies have suggested that older patients have worse outcomes following radical cystectomy (RC) for urothelial carcinoma of the bladder (UCB). We evaluated the association of patient age with clinical outcomes in a large multi-institutional RC series. Data were collected from 4,429 patients treated with RC and lymphadenectomy for UCB without neoadjuvant chemotherapy. Age at RC was analyzed both as a continuous and categorical variable. Higher age at RC, analyzed as a continuous or categorical variable, was associated with advanced pathologic stage (P ANDlt; 0.001), higher tumor grade (P = 0.045), presence of lymphovascular invasion (P = 0.018), and positive soft-tissue surgical margin status (P = 0.004). Elderly patients were less likely to receive postoperative chemotherapy (P ANDlt; 0.001). In multivariable analyses, higher age was associated with disease recurrence, cancer-specific, and overall mortality (P ANDlt; 0.001). Patients a parts per thousand yen80 years had a significantly greater risk of cancer-specific mortality than patients ANDlt; 50 years (HR 1.763, P ANDlt; 0.001). Age minimally improved the accuracy of a base model that included standard pathologic features for prediction of disease recurrence (+0.2-0.3%) and cancer-specific survival (+0.3%). Conversely, age improved the predictive accuracy for overall survival by a sizeable margin (+4.2-4.5%). This large external validation study confirms that advanced patient age is minimally but significantly associated with worse prognosis after RC. Nevertheless, a large proportion of elderly patients benefitted from RC with curative intent. We need to improve our understanding of the reasons for the worse UCB outcomes in this growing segment of the population and to develop strategies to improve cancer care in the elderly.
- Find related publications in this database (using NLM MeSH Indexing)
- Age Factors -
- Aged -
- Aged, 80 and over -
- Carcinoma, Transitional Cell - diagnosis
- Cystectomy - methods
- Female -
- Humans -
- Lymph Node Excision -
- Male -
- Middle Aged -
- Multivariate Analysis -
- Neoplasm Recurrence, Local -
- Prognosis -
- Survival Rate -
- Treatment Outcome -
- Urinary Bladder Neoplasms - diagnosis
- Urothelium - pathology
- Find related publications in this database (Keywords)
- Age
- Prognosis
- Radical cystectomy
- Survival
- Urothelial carcinoma