May, Matthias and Fritsche, H. -M. and Gilfrich, C. and Brookman-May, S. and Burger, M. and Otto, W. and Bolenz, C. and Trojan, L. and Herrmann, E. and Michel, M. S. and Wuelfing, C. and Tiemann, A. and Mueller, S. C. and Ellinger, J. and Buchner, A. and Stief, C. G. and Tilki, D. and Wieland, W. F. and Hoefner, T. and Hohenfellner, M. and Haferkamp, A. and Roigas, J. and Mueller, O. and Bretschneider-Ehrenberg, P. and Zacharias, M. and Gunia, S. and Bastian, P. J. (2011) Influence of older age on survival after radical cystectomy due to urothelial carcinoma of the bladder Survival analysis of a German multi-centre study after curative treatment of urothelial carcinoma of the bladder. UROLOGE, 50 (7). pp. 821-829. ISSN 0340-2592,
Full text not available from this repository. (Request a copy)Abstract
The therapeutic gold standard of muscle-invasive tumour stages is radical cystectomy (RC), but there are still conflicting reports about associated morbidity and mortality and the oncologic benefit of RC in elderly patients. The aim of the present study was the comparison of overall (OS) and cancer-specific survival (CSS) in patients < 75 and > 75 years of age (median follow-up was 42 months). Clinical and histopathological data of 2,483 patients with urothelial carcinoma and consecutive RC were collated. The study group was dichotomized by the age of 75 years at RC. Statistical analyses comprising an assessment of postoperative mortality within 90 days, OS and CSS were assessed. Multivariate logistic regression and survival analyses were performed. The 402 patients (16.2%) with an age of a parts per thousand yen75 years at RC showed a significantly higher local tumour stage (pT3/4 and/or pN+) (58 vs 51%; p=0.01), higher tumour grade (73 vs 65%; p=0.003) and higher rates of upstaging in the RC specimen (55 vs 48%; p=0.032). Elderly patients received significantly less often adjuvant chemotherapy (8 vs 15%; p < 0.001). The 90-day mortality was significantly higher in patients a parts per thousand yen75 years (6.2 vs 3.7%; p=0.026). When adjusted for different variables (gender, tumour stage, adjuvant chemotherapy, time period of RC), only in male patients and locally advanced tumour stages was an association with 90-day mortality noticed. The multivariate analysis showed that patients a parts per thousand yen75 years of age have a significantly worse OS (HR=1.42; p < 0.001) and CSS (HR=1.27; p=0.018). An age of a parts per thousand yen75 years at RC is associated with a worse outcome. Prospective analyses including an assessment of the role of comorbidity and possibly age-dependent tumour biology are warranted.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | CANCER-SPECIFIC SURVIVAL; THERAPY; YOUNGER; IMPACT; Bladder cancer; Urothelial carcinoma; Radical cystectomy; Age; Overall survival |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Urologie |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 09 Jun 2020 06:14 |
| Last Modified: | 09 Jun 2020 06:14 |
| URI: | https://pred.uni-regensburg.de/id/eprint/20630 |
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