Abstract
ABSTRACTObjective:To compare outcome of laparoscopic radical cystectomy (LRC) with ileal conduit in 22 elderly (≥75 years) versus 51 younger (<75 years) patients.Materials and Methods:Analysis of prospectively gathered data of a single institution LRC only series was performed. Selection bias for LRC versus non-surgical treatments was assessed with data retrieved from the Netherlands Cancer Registry.Results:Median age difference between LRC groups was 9.0 years. (77.0 versus 68.0 years). Both groups had similar surgical indications, body mass index and gender distribution. Charlson Comorbidity Index score was 3 versus 4 in ≥50% of younger and elderly patients. Median operative time (340 versus 341 min) and estimated blood loss (<500 versus >500mL) did not differ between groups. Median total hospital stay was 12.0 versus 14.0 days for younger and elderly patients. Grade I-II 90-d complication rate was higher for elderly patients (68 versus 43%, p=0.05). Grade III-V 90-d complication rate was equal for both groups (23 versus 29%, p=0.557). 90-d mortality rate was higher for elderly patients (14 versus 4%, p=0.157). Median follow-up was 40.0 months for younger and 57.0 months for elderly patients. Estimated overall and cancer-specific survival at 5years. was 46% versus 35% and 64% versus 64% for younger and elderly patients respectively.Conclusions:Our results suggest that LRC is feasible in elderly patients, where a non-surgical treatment is usually favoured.
Highlights
Bladder cancer (BC) rates are highest in people aged 75-84 years old, with a median age of 73 at diagnosis [1]
To evaluate possible selection bias for surgery vs. other treatment modalities, data concerning primary treatment modalities applied, age and comorbidity for all patients diagnosed with ≥cT1-4 N0-3, x M0-1, x BC at our hospital within the study period were retrieved from the Netherlands Cancer Registry
The median age difference compared to patients
Summary
To compare outcome of laparoscopic radical cystectomy (LRC) with ileal conduit in 22 elderly (≥75 years) versus 51 younger (
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