The prognostic significance of advanced age in patients with bladder cancer treated with radical cystectomy

Abstract

Objective: To evaluate the association of patient age with pathological and long-term oncological outcomes after radical cystectomy (RC) for bladder carcinoma, as this disease, like many others, increases in incidence with age.

Patients and methods: We retrospectively reviewed 241 consecutive patients with invasive bladder cancer who had RC between 1990 and 2007. The age at RC was analysed both as a continuous and categorical (< or =50 years, 38 patients; 51-69, 172; or > or =70, 31) variable. Survival was also analysed.

Results: Increasing age, analysed as a continuous and categorical variable, was associated with advanced pathological stage (P = 0.009 and 0.006, respectively). The 5-year cancer-specific survival rates for patients according to the age groups were 78.5%, 44.9% and 28.1%, respectively, and Kaplan-Meier analysis showed an increased risk of bladder cancer-specific death with advancing age (P < 0.001). Being older at RC was an important prognostic factor for disease-specific survival in a multivariate Cox regression model. Patients aged > or =70 years had a significantly higher risk of disease than patients aged < or =50 years (P = 0.002).

Conclusions: Higher age at RC is significantly associated with the risk of pathologically advanced disease and poorer cancer-specific survival. More prospective work is needed to examine the impact of age on tumour biology and cancer-specific survival.