[Radical cystectomy as a muscle-invasive bladder cancer treatment in elderly patients]. / Cistectomía radical como tratamiento del cáncer vesical infiltrante en el paciente de edad avanzada.

INTRODUCTION: Radical cystectomy in elderly is a controversial issue that increases importance overtime because average life span is growing. OBJECTIVE: The purpose of our work was to analize the differences about perioperative and later outcomes between ages of patients with muscle-invasive bladder neoplasm treated with radical cystectomy. MATERIAL AND METHODS: We retrospectively reviewed the records of patients who underwent radical cystectomy for muscle-invasive bladder cancer. Two age groups were compared: < 70-years-old at time of cystectomy (n = 55) and > or = 70 years (n = 57). RESULTS: There was no difference between both age groups about: time of surgery, intraoperative complications (< 70 = 21,8%, > or = 70 = 31,6%), postoperative mortality (< 70 = 3,6%, > or = 70 = 8,8%), minor (< 70 = 18,2%, > or = 70 = 26,3%) and major medical postoperative complications (< 70 = 7,3%, > or = 70 = 8,8%), late outcomes as cancer-specific morby-mortality and actuarial overall survival stratified by patient age. The rate of major postoperative complications (< 70 = 23,6%, > or = 70 = 43,9%) as well as the mean length of hospital stay (< 70 = 10,2, > or = 70 = 15,2 days) differed significantly between the two age groups. Age and cardiovascular risk factors were independient predictive factors of mayor postoperative complications. CONCLUSIONS: Radical cystectomy could be performed in carefully selected elderly patients.

Cistectomía radical como tratamiento del cáncer vesical infiltrante en el paciente de edad avanzada / Radical cystectomy as a muscle-invasive bladder cancer treatment in elderly patients

Introducción: Realizar una cistectomía radical en ancianos con cáncer vesical infiltrante es un tema controvertido. Objetivo: El objetivo de nuestro trabajo ha sido determinar si existen diferencias significativas en cuanto a la morbimortalidad perioperatoria, complicaciones tardías, tiempo libre de enfermedad y supervivencia cáncer-específica en un grupo de pacientes ancianos con cáncer vesical infiltrante tratados mediante cistectomía radical, comparado al resto de pacientes de menor edad y analizar qué variables pudieron predecir la morbi-mortalidad perioperatoria. Material y métodos: Estudio retrospectivo de pacientes con cáncer vesical infiltrante tratados mediante cistectomía radical y derivación ileal. Se compararon 2 grupos: <70 años en el momento de la realización de la cistectomía (n=55) y≥70 años (n=57). Resultados: No hubo diferencias entre ambos grupos con respecto a: tiempo quirúrgico, complicaciones intraoperatorias (<70=21,8%, ≥70=31,6%), mortalidad postoperatoria (<70=3,6%, ≥70=8,8%), complicaciones postoperatorias menores(<70=18,2%, ≥70=26,3%) y médicas (<70=7,3%, ≥70=8,8%), eventos tardíos, periodo libre de enfermedad y supervivencia cáncer-específica. El porcentaje de complicaciones mayores (<70=23,6%, ≥70=43,9%) y la estancia hospitalaria (<70=10,2,≥70=15,2 días) difieren significativamente entre ambos grupos. La edad y los factores de riesgo cardiacos predicen de manera independiente la aparición de complicaciones postoperatorias mayores. Conclusiones: La cistectomía radical puede ser realizada en pacientes ancianos seleccionados adecuadamente (AU)

Introduction: Radical cystectomy in elderly is a controversial issue that increases importance overtime because average life span is growing. Objetive: The porpouse of our work was to analize the differences about perioperative and later outcomes between ages of patients with muscle-invasive bladder neoplasm treated with radical cystectomy. Material and methods: We retrospectively reviewed the records of patients who underwent radical cystectomy for muscle-invasive bladder cancer. Two age groups were compared: <70 years old at time of cystectomy (n=55) and ≥70 years(n=57).Results: There was no difference between both age groups about: time of surgery, intraoperative complications (<70=21,8%,≥70=31,6%), postoperative mortality (<70=3,6%, ≥70=8,8%), minor (<70=18,2%, ≥70=26,3%) and major medical postoperative complications (<70=7,3%, ≥70=8,8%), late outcomes as cancer-specific morby-mortality and actuarial overall survival stratified by patient age. The rate of major postoperative complications (<70=23,6%, ≥70=43,9%) as well as the mean length of hospital stay (<70=10,2, ≥70=15,2 days) differed significantly between the two age groups. Age and cardiovascular risk factors were independient predictive factors of mayor postoperative complications. Conclusions: Radical cystectomy could be performed in carefully selected elderly patients (AU)