BACKGROUND and OBJECTIVE:
The risk to benefit ratio of the surgical treatment of Muscle Invasive Bladder Cancer (MIBC) in patients aged ≥ 80 years has not been objectively and comprehensively quantified. Herein, we aim to compare the outcomes of radical cystectomy (RC) among patients ≥ 80 years.
METHODS:
Data from six UK tertiary referral uro-oncology centers was tallied and interrogated for demographic and outcome parameters. Between September 2010 and December 2016, a total of 80 patients ≥ 80 years underwent RC and ileal conduit formation. These patients were compared with 80 patients in the under 80 yrs age group in the same time frame. Outcome parameters included total operative time, length of total hospital stay, impact of lymph node dissection, resection margins, in-patient complications and 30 day complications.
RESULTS:
The median overall age for all patients was 80yrs (range42–88) [79yrs(42–79) for under 80s & 82yrs (80-88) for ≥ 80]. There were a total of 160 patients [128(80% )male & 32 (20%) female]. The majority of patients had ASA grade of 2 or 3. There were no significant differences in rates of in-patient complications (p>0.46) and 30-day complications (p>0.20) between those were under 80 and ≥80. There was no difference in survival at early and medium term followup.
CONCLUSIONS:
In patients 80 and over with MIBC, favourable outcomes can be achieved in dedicated tertiary referral pelvic uro-oncology centers following RC. The risk to benefit ratio should be weighed carefully and age should not be considered a barrier. Large scale multicentre studies with long-term followup are indicated.