Uekado Yasunari, Inagaki Takeshi, Hagino Keizou, Suzuki Atsushi, Shinka Toshiaki
The Department of Urology, Wakayama Medical University.
Hinyokika Kiyo. 2005 Aug;51(8):547-51.
Between 1995 and 2004, 43 patients underwent radical cystectomy and urinary diversion for the treatment of invasive bladder cancer at our institution. Of these patients, seven who were 75 years old or older, were considered elderly. Survival and treatment outcome of these patients were compared to younger counterparts stratified into three groups by age at diagnosis (12 patients younger than 64, 12 patients 65 to 69 years, and 12 patients 70 to 74 years). Preoperative morbidity was encountered in 57% of the elderly patients, and 42% of the elderly patients had two or more complications. There was one operative death (14%) among the elderly patients but no such deaths in the 3 younger groups. The postoperative complication rate for patients age 75 years or older was 86%, compared to 75% for patients younger than 64, 75% for those age 65 to 69 and 83% for those age 70-74. The prevalence did not differ significantly between the older and youger patients. There were no cancer deaths among the elderly patients, but 8 of the 36 younger patients died of cancer. The cancer-specific 5-year survival rate was 100% at 34 months in the elderly population. These findings suggest that radical cystectomy and urinary diversion is a relatively safe procedure and a curative operation is worth attempting in elderly patients with invasive bladder cancer, if they are in generally good health.
1995年至2004年间，我院有43例患者因浸润性膀胱癌接受了根治性膀胱切除术及尿流改道术。其中，7例年龄在75岁及以上的患者被视为老年患者。将这些患者的生存及治疗结果与按诊断时年龄分为三组的年轻患者进行比较（12例年龄小于64岁，12例年龄在65至69岁，12例年龄在70至74岁）。57%的老年患者术前出现并发症，42%的老年患者有两种或更多并发症。老年患者中有1例手术死亡（14%），而3个较年轻组中无此类死亡。75岁及以上患者的术后并发症发生率为86%，相比之下，年龄小于64岁患者为75%，65至69岁患者为75%，70至74岁患者为83%。老年和年轻患者之间患病率无显著差异。老年患者中无癌症死亡，但36例年轻患者中有8例死于癌症。老年人群中癌症特异性5年生存率在34个月时为100%。这些发现表明，根治性膀胱切除术及尿流改道术是一种相对安全的手术，对于健康状况总体良好的老年浸润性膀胱癌患者，根治性手术值得尝试。
