[Geriatric assessment and treatment of nonmetastatic muscle-invasive bladder cancer in patients over 75 years of age. Retrospective and multicentric study of 121 cases]

Abstract

Objective: The aim of our study was to assess prevalence of geriatric assessment (GA) in patients over 75years with nonmetastatic invasive bladder cancer (MIBC).

Material and methods: We performed a retrospective study between 2000 and 2015. We assessed comobidity by Charlson score and ASA score, geriatric assessement (GA) and treatments.

Results: One hundred and twenty one patients were inclued. Median age was 81 (73-95) at diagnosis. Thirty nine patients (32%) were evaluated by GA, G8 screening tool was performed in 16% of patients. Patients without GA were older (82 vs. 81years) and had less comorbidities (Charlson≥2 à 61% vs. 69%). Seventy-four percent of patients received a curarive therapy: 60% were treated by RC, 9% by chemoradiotherapy, 26% received palliative therapy and 15% were only in observation.

Conclusion: Patients with MIBC over 75years were less evaluated and less treated. Patients in pallative care received mostly observation. Although practices have improved, GA was underused. Care of these patients needs standardization in order to adapt therapeutic to their comorbidities and to treat them with curative intent.

Level of proof: 4.

Keywords: Bladder invasive cancer; Cancer de vessie infiltrant; Complications post-cystectomie; Elderly; Oncogeriatry; Oncogériatrie; Patients âgés; Postoperative complications.