Evaluation of Cause of Death After Radical Cystectomy for Patients With Bladder Cancer: The Impact of Age at the Time of Surgery

Marco Moschini, Alberto Martini, Stefania Zamboni, Agostino Mattei, Philipp Baumeister, Carlo Di Bona, Paolo Dell'Oglio, Emanuele Zaffuto, Giusy Burgio, Shahrokh F. Shariat, Rafael Sanchez-Salas, Xavier Cathelineau, Andrea Salonia, Francesco Montorsi, Alberto Briganti, Andrea Gallina, Renzo Colombo

Research output: Contribution to journalArticle

Abstract

Introduction: Patients with bladder cancer treated with radical cystectomy (RC) have heterogeneous results in term of cancer-specific (CSM) and other cause mortality (OCM). Our aim is to assess the impact of age on cause of death after RC. Patients and Methods: We retrospectively analyzed the data of 1222 patients treated with RC and bilateral pelvic lymph node dissection owing to nonmetastatic bladder cancer between 1990 and 2013. Patients were stratified according to age (< 59 vs. 60-69 vs. 70-79 vs. ≥ 80 years), tumor T stage at RC (pT0-T2 vs. pT3-T4), and tumor N stage at RC (pN+ vs. pN0). Competing-risks survival analyses were used to estimate CSM and OCM rates. Results: With a median follow up of 6 years, 92 (7.5%) and 385 (31.5%) OCM and CSM were recorded. The 5-year CSM and OCM rates were 40% and 8.8%, respectively. After stratification according to disease stage and patient age, CSM emerged as the main cause of mortality in all patient subgroups. The 5-year OCM was 4.6%, 4.8%, 11%, and 32% for patients aged < 60 years versus 60 to 69 years versus 70 to 79 years versus ≥ 80 years, respectively. The 5-years CSM was 34%, 45%, 35%, and 56% for patients aged < 60 years versus 60 to 69 years versus 70 to 79 years versus ≥ 80 years, respectively. Similar findings were observed stratifying the population according to pathologic T and N stage. Conclusion: CSM is the preponderant cause of death for all the patients, regardless of age or stage. In this regard, RC also seems to be a reasonable approach for octogenarians.

Original languageEnglish
Pages (from-to)e541-e548
JournalClinical Genitourinary Cancer
Volume17
Issue number3
DOIs
Publication statusPublished - Jun 2019

Keywords

  • Bladder cancer
  • Radical cystectomy
  • Urochelial cancer
  • Urthelial carcinoma of the bladder

ASJC Scopus subject areas

  • Oncology
  • Urology

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    Moschini, M., Martini, A., Zamboni, S., Mattei, A., Baumeister, P., Di Bona, C., Dell'Oglio, P., Zaffuto, E., Burgio, G., Shariat, S. F., Sanchez-Salas, R., Cathelineau, X., Salonia, A., Montorsi, F., Briganti, A., Gallina, A., & Colombo, R. (2019). Evaluation of Cause of Death After Radical Cystectomy for Patients With Bladder Cancer: The Impact of Age at the Time of Surgery. Clinical Genitourinary Cancer, 17(3), e541-e548. https://doi.org/10.1016/j.clgc.2019.02.001