INTRODUCTION - Radical cystectomy in elderly patients is a controversial issue that has noticed an increase in importance overtime because of the lengthening average life span. Our objective was to determine if there were significant differences in the perioperative outcomes of patients over 70 years with bladder cancer treated with laparoscopic radical cystectomy (LRC) compared to those of younger patients.
METHODS - We selected 180 patients who underwent LRC in our department in the period between 2005-2012. We divided them into 2 groups: 57% 70 years, and we compared the different parameters such as: comorbidities, intraoperative and post-operative complications, TNM stage and overall survival.
RESULTS - The group 70 years. Heterotopic urinary diversion was the diversion of choice in the elderly patients (97.4%). Paralytic ileus and the worsening of renal function were the only complications with statistical differences between the groups. Mean hospital length of stay was not significantly different between the groups. Younger and older patients had similar pathological staging : pT1 or less: 26,2 vs. 18.2%, pT2: 19.4 vs. 16.9%, pT3 38.8 vs. 37.7% and pT4 15.6 vs. 17.2%. Kaplan-Meier curves did not show significant differences in survival.
CONCLUSIONS - Laparoscopic radical cystectomy in the elderly patient has similar rates of perioperative morbidity when compared with the younger patient and may be offered as a treatment option in selected elderly patients.
Cent European J Urol. 2015;68(1):24-9. doi: 10.5173/ceju.2015.01.498. Epub 2015 Mar 13.
Fontana PP1, Gregorio SA1, Rivas JG1, Sánchez LC1, Ledo JC1, Gómez ÁT1, Sebastián JD2, Barthel JJ1.
1 Department of Urology, Hospital Universitario La Paz, Madrid, Spain.
2 Department of Biostatistics, Hospital Universitario La Paz, Madrid, Spain.