1846 COMPARATIVE SURVIVAL FOLLOWING DIFFERENT TREATMENT MODALITIES FOR STAGE T2- MUSCLE INVASIVE BLADDER CANCER IN OCTOGENARIANS- A POPULATION BASED STUDY

Abstract

You have accessJournal of UrologyBladder Cancer: Invasive1 Apr 20111846 COMPARATIVE SURVIVAL FOLLOWING DIFFERENT TREATMENT MODALITIES FOR STAGE T2- MUSCLE INVASIVE BLADDER CANCER IN OCTOGENARIANS- A POPULATION BASED STUDY Naveen Pokala, Piyush Agarwal, Ravi P. Kiran, Sumit De, Emil Kheterpal, James Peabody, and Mani Menon Naveen PokalaNaveen Pokala Detroit, MI More articles by this author , Piyush AgarwalPiyush Agarwal Detroit, MI More articles by this author , Ravi P. KiranRavi P. Kiran Cleveland, OH More articles by this author , Sumit DeSumit De Detroit, MI More articles by this author , Emil KheterpalEmil Kheterpal Detroit, MI More articles by this author , James PeabodyJames Peabody Detroit, MI More articles by this author , and Mani MenonMani Menon Detroit, MI More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2011.02.1879AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Introduction: Anticipated higher operative risk and higher incidence of co-morbidities in octogenarians may influence urologists in opting for less aggressive modalities of treatment. This population-based study analyzes and compares survival after different modalities of treatment in patients with stage T2 muscle invasive bladder cancer in octogenarians. METHODS Patients that were 80 years or older diagnosed with T2 muscle invasive transitional cell bladder cancer (TCC) between 1988 and 2008 were identified from the SEER 17 database and included in the study. Patients were studied for demographics, stage at presentation, treatment modality and overall and cancer-specific survival. Patients with other histology, incomplete data, diagnosed at autopsy, distant disease, Ta, T1, T3 and T4 stages were excluded. Appropriate statistical methods were used. RESULTS 3232 patients met inclusion criteria, the mean age was 85.5± 4.3 years, 38.2% (N=1234) were female, 90.6% were white, 5.1% were black and 4.3% belonged to other races. 6 % were T2a (n=195), 8.4% were T2 b ( n=270), and 85.6% were T2 NOS. The nodal status at diagnosis was N0 (n=1323), N1 (n=17), N2 (n=11) and N3 (n=1). 2216 patients underwent endoscopic procedures alone, 108 underwent partial cystectomy, 2 patients underwent pelvic extenteration, 2 patients underwent exploratory laparotomy, 156 underwent radical cystectomy, 733 patients underwent RT and 15 patients underwent total cystectomy. The median and mean overall (OS) and cancer specific survival (CSS) following endoscopic procedure, partial cystectomy, total cystectomy, radical cystectomy and endoscopic resection with RT is shown in Table 1. Table 1. Median and mean overall survival in months Primary procedure Median OS Mean OS Median CSS Mean CSS Endoscopic procedure 11 27.1 11 33.6 TURBT and RT 14 30.5 13 30.7 Radical Cystectomy 40 60.8 59 86.1 Partial Cystectomy 37 57.5 54 78.5 Cystectomy 39 59.2 30 45.4 Whole Group 13 30.7 13 38.4 There was no significant difference noted in the age, gender or, T stage between the different Treatment groups. On multivariate analysis the age at diagnosis, T stage, N stage and treatment modality was a predictor of overall and cancer specific survival. CONCLUSIONS Cystectomy (partial or radical) offers a significant survival advantage over endoscopic resection or endoscopic resection followed by radiation to patients over 80 years of age with T2 transitional cell carcinoma of the bladder and should be offered as the treatment of choice to Octogenarians with stage T2 TCC of the bladder. © 2011 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 185Issue 4SApril 2011Page: e740-e741 Advertisement Copyright & Permissions© 2011 by American Urological Association Education and Research, Inc.MetricsAuthor Information Naveen Pokala Detroit, MI More articles by this author Piyush Agarwal Detroit, MI More articles by this author Ravi P. Kiran Cleveland, OH More articles by this author Sumit De Detroit, MI More articles by this author Emil Kheterpal Detroit, MI More articles by this author James Peabody Detroit, MI More articles by this author Mani Menon Detroit, MI More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...