Radical Cystectomy in the Octogenarian Population: A Single Centre Experience

Abstract

Introduction: Radical cystectomy is the treatment of choice for infiltrating non-metastatic bladder cancer. However there is reluctance to perform this surgery in the elderly due to morbidities associated. We sought to examine our institutional experience regarding radical cystectomy in the octogenarians. Patients and Methods: A total of 23 were 80 years or older in age (19 males and 4 females). Overall mortality, early and late morbidity were analyzed. Length of hospital stay, intensive therapy unit admissions, re-hospitalization and overall survival were assessed. Results: Median age at time of cystectomy was 83.5 years (range 80–90 years). Median follow-up time was 7.5 years (range 8–120 months). All patients had standard radical cystectomy. Median operative time was 3 hours (range 3–5 hours). Median number of blood transfusion units was 9 (range 4–14). Median preoperative and postoperative hemoglobin level was 12.5 (range 9.9–14) and 10.8 g/dl (8.7–12.2 g/dl) respectively. Admission to the intensive therapy unit was needed in 3 patients. Median number of hospitalization days following the cystectomy procedure was 23 days (range 5–90 days). Median survival time was 16 months and the actuarial survival at 1, 2 and 3 year was 66.7, 47.6 and 12% respectively. Conclusion: This study highlights the safety and feasibility of radical cystectomy in the treatment of bladder cancer in the octogenarians. It provides palliation of local symptoms and local cancer control. Future research should be directed towards comparing with the non-octogenarian cohorts with particular emphasis on oncological, functional and survival outcomes as end points.