Abstract
You have accessJournal of UrologyCME1 Apr 2023MP75-11 AGE GREATER THAN 80 ALONE SHOULD NOT BE A CONTRAINDICATION FOR CYSTECTOMY AND URINARY DIVERSION Arighno Das, Tudor Borza, Daniel Shapiro, E. Jason Abel, David Jarrard, and Kyle Richards Arighno DasArighno Das More articles by this author , Tudor BorzaTudor Borza More articles by this author , Daniel ShapiroDaniel Shapiro More articles by this author , E. Jason AbelE. Jason Abel More articles by this author , David JarrardDavid Jarrard More articles by this author , and Kyle RichardsKyle Richards More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003349.11AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Previous literature has revealed that older patients with muscle invasive bladder cancer are less likely to undergo definitive treatment including cystectomy. As cystectomy is a potentially morbid operation, there are concerns that older patients may have worse outcomes. This study evaluated peri-operative outcomes of patients aged greater than 80 following cystectomy. METHODS: A retrospective database was created, consisting of 370 consecutive patients who underwent cystectomy with urinary diversion from 2015 to 2022 by a single surgeon. Relationships between age and clinical parameters were assessed using T-tests, Chi-squared tests, and multivariable analysis. RESULTS: Of the 370 patients, 42 (11%) were 80 years or older at the time of cystectomy. Baseline characteristics between the two groups are shown in Table 1. Older patients were more likely to undergo incontinent diversions (100% vs. 86%, p=0.009), have shorter OR times (275 min vs. 380 min, p<0.001), and undergo robotic approach less frequently (33% vs. 45%, p=0.2). No differences in mean Charlson Comorbidity Index (CCI) were noted between the two groups (0.98 vs. 1.18, p=0.9). There were no differences in median length of stay (LOS) (7 days vs. 7 days, p=0.7), 30-day readmission rate (31% vs. 32%, p>0.9), or rate of Clavien-Dindo≥III complication within 30 days (12% vs. 10%, p=0.8) between the two groups. When controlling for surgical approach, diversion type, and CCI, age greater than 80 was not associated with LOS, risk of 30-day readmission, or risk of Clavien-Dindo≥III complication within 30 days (Figure 1). CONCLUSIONS: Age greater than 80 was not associated with worse peri-operative outcomes following cystectomy. Patient selection is critical, as our cohort of patients above 80 had similar CCI compared to younger patients. These results suggest that in a well-selected patient, age alone should not be a contraindication for cystectomy. Source of Funding: N/A © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e1084 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Arighno Das More articles by this author Tudor Borza More articles by this author Daniel Shapiro More articles by this author E. Jason Abel More articles by this author David Jarrard More articles by this author Kyle Richards More articles by this author Expand All Advertisement PDF downloadLoading ...
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