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. 2022 Feb 15:14:603-613.
doi: 10.2147/CMAR.S350587. eCollection 2022.

Comparative Study of Perioperative and Oncological Outcomes Between Elderly Patients and Younger Patients Who Received Radical Cystectomy and Pelvic Lymph Node Dissection: A Single-Center Retrospective Study

Haixin Wang #  1   2   3   4 , Haiwen Huang #  1   2   3 , Meixia Shang  5 , Han Hao  1   2   3 , Zhijun Xi  1   2   3
Affiliations

Comparative Study of Perioperative and Oncological Outcomes Between Elderly Patients and Younger Patients Who Received Radical Cystectomy and Pelvic Lymph Node Dissection: A Single-Center Retrospective Study

Haixin Wang et al. Cancer Manag Res. .

Abstract

Purpose: To compare the perioperative and survival outcomes of patients over 75 years and younger patients who received radical cystectomy.

Patients and methods: A total of 119 patients aged ≥75 years and 488 patients aged <75 years were enrolled. All patients underwent radical cystectomy with pelvic lymph node dissection. Clinical characteristics and perioperative outcomes were compared between the two groups. Overall survival and progression-free survival were analyzed by using the Kaplan-Meier method. Cox regression analysis and logistic regression analysis were used to identify the risk factors affecting the outcomes observed.

Results: There was no significant difference in perioperative complications between the elderly patient group and the younger patient group (p = 0.349). The 5-year overall survival of elderly patients was lower than that of young patients (p < 0.001). Age ≥75 years was a risk factor for overall survival (HR = 1.69 [95% CI: 1.22-2.35]; p = 0.002) and progression-free survival (HR = 1.69 [95% CI: 1.14-2.50]; p = 0.008) for patients who received radical cystectomy but was not a poor risk factor for major complications (HR = 1.25 [95% CI: 0.47-3.31]; p = 0.658) after radical cystectomy. In addition, preoperative renal insufficiency was associated with a higher risk of major complications.

Conclusion: In our cohort, compared with younger patients, elderly patients aged ≥75 years had worse survival outcomes, but age ≥75 years was not a risk factor for major complications after radical cystectomy with pelvic lymph node dissection. Radical surgery should be encouraged for elderly patients who can tolerate aggressive treatments.

Keywords: complications; elderly; radical cystectomy; survival outcomes.

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Conflict of interest statement

The authors declare that they have no conflicts of interest.

Figures

Figure 1
Figure 1
Kaplan–Meier curves of OS probability (p < 0.001), PFS (p =0.131), and CSS probability (p = 0.065) in elderly patients and younger patients who received radical cystectomy and pelvic lymph node dissection. The 5-year OS of elderly patients and young patients was 0.456 versus 0.628, respectively. The 5-year PFS was 0.620 versus 0.670, and the 5-year CSS was 0.638 versus 0.725 in the elderly patient group and the young patient group, respectively.
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Comment in

  • Geriatrics.
    Griebling TL. Griebling TL. J Urol. 2022 Dec;208(6):1326-1328. doi: 10.1097/JU.0000000000002986. Epub 2022 Oct 4. J Urol. 2022. PMID: 36194655 No abstract available.

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