Korean J Urol Oncol.  2022 Aug;20(3):186-196. 10.22465/kjuo.2022.20.3.186.

Comparison of Perioperative and Oncologic Outcome Between Old Versus Oldest Old After Radical Cystectomy for Bladder Cancer

• Park SS
• Lee CU
• Chung JH
• Song W
• Kang M
• Sung HH
• Jeon HG
• Seo SI
• Jeon SS
• Lee HM
• Jeong BC

• KMID: 2533089
• DOI: http://doi.org/10.22465/kjuo.2022.20.3.186

Abstract

Purpose
The purpose of study was to compare oncologic outcomes (recurrence-free survival [RFS], cancer-specific survival [CSS], and overall survival [OS]) and early complication (within 30 days) after radical cystectomy (RC) between old patients (70–79 aged) and oldest-old patients (above 80).
Materials and Methods
This retrospective study reviewed total 340 patients with urothelial carcinoma of bladder who received RC between November 1996 and December 2018. The patients were divided into 2 groups by age, 307 patients aged 70–79 and 33 patients aged above 80. Baseline characteristics, perioperative outcomes and early complication were compared between the 2 groups. Kaplan–Meier (K-M) survival analysis was used to estimate RFS, CSS, OS, and multivariable Cox proportional hazard models were used to identify factors predicting RFS, CSS, OS.
Results
The results of both groups did not statistically differ from each other in most clinicopathologic baseline characteristics and perioperative information. Both groups showed similar 30-day complication rates (59.3% vs. 60.3%, p=0.210). K-M showed 3-year survival rate, RFS was shorter in oldest-old group (41.4% vs. 56.7%) but not statistically different (p=0.063). Oldest-old group showed similar 3-year CSS (78.1% vs. 74.6%, p=0.779) but worse OS (51% vs. 58%, p=0.047) compared with the old group. Common factor affecting RFS, CSS, and OS were T stage and N stage (all p<0.05). Age is not factor affecting RFS, CSS, and OS.
Conclusions
Oldest-old who received RC had similar perioperative, oncologic outcome and complication compared with the seventies. RC could be considered treatment option for selected oldest-old patients.

Keyword

Radical cystectomy; Octogenarians; Bladder cancer; Survival; Complications