The natural history of muscle-invasive bladder cancer in geriatric patients undergoing transurethral resection only: Outcome and cost.
Urol Oncol
; 39(5): 300.e7-300.e13, 2021 05.
Article
en En
| MEDLINE
| ID: mdl-33308977
ABSTRACT
PURPOSE:
Bladder cancer is predominant in the elderly. Up to 70% of geriatric patients with muscle-invasive bladder cancer do not receive curative treatment. We analyzed the outcome of patients managed only by transurethral resection of bladder tumor (TURBT) without chemo- or radio-therapy, and performed a cost analysis of the cumulative inpatient interventions throughout the course of the disease.METHODS:
From 2010 to 2016 81 patients ≥75 years with de novo muscle-invasive bladder cancer who were not eligible for curative treatment options were analyzed retrospectively. All patients were treated only with TURBT. Overall survival (OS) was measured by Kaplan-Meier plots (log-rank test) and clinical parameters predicting OS by a multivariate analysis. The cost analysis was based on actual billing from the hospital provider and referenced standardized pricing in Germany for bladder cancer treatment.RESULTS:
The median age was 83 years. The OS was 11 months, the 1-year OS was 42%. In the multivariate model Charlson Comorbidity Index <8 (Pâ¯=â¯0.016), tumor size ≤3 cm (Pâ¯=â¯0.011), complete (T0) tumor resection (Pâ¯=â¯0.003), normal C-reactive protein level (Pâ¯=â¯0.010), and initial elective surgery (Pâ¯=â¯0.035) were shown to be independent predictors of longer OS in palliative TURBT regimes. Median treatment cost for the TURBT regimen was $16,175 vs. $16,467 for a salvage radical cystectomy in this cohort.CONCLUSIONS:
In a TURBT-only concept elective surgery, tumor size, Charlson Comorbidity Index, C-reactive protein level and complete TURBT are independent predictors of OS. The treatment-related cumulative cost appears to be higher in patients not managed by cystectomy.Palabras clave
Texto completo:
1
Bases de datos:
MEDLINE
Asunto principal:
Neoplasias de la Vejiga Urinaria
/
Cistectomía
/
Costos y Análisis de Costo
Tipo de estudio:
Health_economic_evaluation
/
Observational_studies
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Prognostic_studies
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Risk_factors_studies
Límite:
Aged
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Aged80
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Female
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Humans
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Male
Idioma:
En
Revista:
Urol Oncol
Asunto de la revista:
NEOPLASIAS
/
UROLOGIA
Año:
2021
Tipo del documento:
Article