Medizinische Universität Graz - Research portal
Selected Publication:
SHR Neuro Cancer Cardio Lipid Metab Microb
Rink, M; Dahlem, R; Kluth, L; Minner, S; Ahyai, SA; Eichelberg, C; Fisch, M; Chun, FKh.
Older patients suffer from adverse histopathological features after radical cystectomy.
Int J Urol. 2011; 18(8):576-84
Doi: 10.1111/j.1442-2042.2011.02794.x
Web of Science
PubMed
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FullText_MUG
- Co-authors Med Uni Graz
- Ahyai Sascha
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- Abstract:
- OBJECTIVES: Radical cystectomy (RC) remains a complex procedure in older patients. Perioperative morbidity can be significant and it can represent a limitation for its indication in this population. The aim of the present study was to evaluate the outcomes of RC in elderly patients from a large single-center cohort. METHODS: A total of 447 patients who underwent RC between 1996 and 2009 at our institution were considered. Patients were stratified by age (≤70 vs >70 years). Logistic regression analyses were carried out comparing both groups regarding clinical, perioperative and histopathological findings, as well as complications according to the modified Clavien system and survival. RESULTS: Data of 390 patients were available for the analysis. Of these, 265 (67.9%) versus 125 (32.1%) patients were <70 versus ≥70 years-of-age. The median age was 61 and 75 years, respectively. In the elderly, ASA score (P < 0.001), delay between transurethral resection of the bladder (TURBT) and RC (P = 0.004), and number of perioperative blood transfusions (P = 0.002) were significantly higher. Additionally, a clear trend towards higher stages (pT3-4) was observed (P = 0.04). However, complications, and overall and cancer-specific mortality were not increased in older patients. Finally, age was identified as a significant risk factor for upstaging (P = 0.04). Upstaging between TURBT and final histopathology in patients <70 versus ≥70 years occurred in 45% versus 58%, respectively (P = 0.03). CONCLUSIONS: RC is equally feasible in older patients without increasing morbidity or mortality. On the contrary, older patients have a higher risk of significant upstaging and advanced stages at final histopathology. These findings suggest that RC should neither be delayed in nor withheld from elderly patients.
- Find related publications in this database (using NLM MeSH Indexing)
- Age Factors - administration & dosage
- Aged - administration & dosage
- Cystectomy - adverse effects
- Female - administration & dosage
- Humans - administration & dosage
- Male - administration & dosage
- Middle Aged - administration & dosage
- Postoperative Complications - epidemiology
- Prospective Studies - administration & dosage
- Survival Rate - administration & dosage
- Urinary Bladder Neoplasms - mortality, pathology, surgery
- Find related publications in this database (Keywords)
- bladder cancer
- elderly
- old patients
- radical cystectomy
- upstaging
- worse histopathology