You have accessJournal of UrologyBladder Cancer: Staging1 Apr 20111902 RADICAL CYSTECTOMY: THE IMPACT OF AGE ON OVERALL SURVIVAL Mariaconsiglia Ferriero, Giuseppe Simone, Rocco Papalia, Salvatore Guaglianone, Maurizio Buscarini, and Michele Gallucci Mariaconsiglia FerrieroMariaconsiglia Ferriero Rome, Italy More articles by this author , Giuseppe SimoneGiuseppe Simone Rome, Italy More articles by this author , Rocco PapaliaRocco Papalia Rome, Italy More articles by this author , Salvatore GuaglianoneSalvatore Guaglianone Rome, Italy More articles by this author , Maurizio BuscariniMaurizio Buscarini Rome, Italy More articles by this author , and Michele GallucciMichele Gallucci Rome, Italy More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2011.02.2026AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES There are poor evidences showing the role of the age on overall survival after radical cystectomy, neither exists a cut off who excludes surgical treatment, when indicated, as a valid treatment option. The aim of the study was to evaluate if age had a prognostic role on global survival and which variables contraindicate surgical therapy in advanced age. METHODS Between March 2001 and March 2009 we selected 522 patients from a prospectively-maintained database of 800 patients undergone radical cystectomy. The mean age was 65.6 years, (range 29 – 86). The whole cohort was divided into 3 subgroups following 2 cut off, using the analysis of variance (ANOVA) and Cox regression. We applied multivariate analysis including pT, pN, cM, LN-density, LN-count and ASA score, to identify independent prognostic factors of global survival. Secondly we performed multivariate analysis in a subgroup of patients with advanced age to identify independent prognostic variables of overall survival. Statistical analysis was performed using SPSS 17. RESULTS The most significant cut off used to stratify the whole cohort into three age subgroups were 65 and 77 years. At log rank test, the overall survival of three subgroups (younger than 65 years [226 patients], between 66 and 77 years [239 patients] and older than 77 years [57 patients]) was statistically different (p<0.001) (Fig 1). In the subgroup of patients older than 77 years the only independent factor of overall survival was ASA score (Cox regression; p=0.008), with a 2-yr survival of 20.6%(ASA score 3–4) vs 60.6% (ASA score 2), (Fig 2). At Cox regression analysis pT (p<0.001), LN-Density (p<0.001), age (p=0.003) and pN(0.033) proved to be independent predictors of overall survival. CONCLUSIONS In our series age was an independent predictor of overall survival and, although radical cystectomy was feasible in elderly, ASA score was a strong predictor of outcome. Elective surgical treatment in octuagenarian patients should be based on preoperative evaluation of health status. © 2011 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 185Issue 4SApril 2011Page: e761 Peer Review Report Advertisement Copyright & Permissions© 2011 by American Urological Association Education and Research, Inc.MetricsAuthor Information Mariaconsiglia Ferriero Rome, Italy More articles by this author Giuseppe Simone Rome, Italy More articles by this author Rocco Papalia Rome, Italy More articles by this author Salvatore Guaglianone Rome, Italy More articles by this author Maurizio Buscarini Rome, Italy More articles by this author Michele Gallucci Rome, Italy More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...