The prognostic significance of advanced age in patients with bladder cancer treated with radical cystectomy.

OBJECTIVE

To evaluate the association of patient age with pathological and long-term oncological outcomes after radical cystectomy (RC) for bladder carcinoma, as this disease, like many others, increases in incidence with age.

PATIENTS AND METHODS

We retrospectively reviewed 241 consecutive patients with invasive bladder cancer who had RC between 1990 and 2007. The age at RC was analysed both as a continuous and categorical (< or =50 years, 38 patients; 51-69, 172; or > or =70, 31) variable. Survival was also analysed.

RESULTS

Increasing age, analysed as a continuous and categorical variable, was associated with advanced pathological stage (P = 0.009 and 0.006, respectively). The 5-year cancer-specific survival rates for patients according to the age groups were 78.5%, 44.9% and 28.1%, respectively, and Kaplan-Meier analysis showed an increased risk of bladder cancer-specific death with advancing age (P < 0.001). Being older at RC was an important prognostic factor for disease-specific survival in a multivariate Cox regression model. Patients aged > or =70 years had a significantly higher risk of disease than patients aged < or =50 years (P = 0.002).

CONCLUSIONS

Higher age at RC is significantly associated with the risk of pathologically advanced disease and poorer cancer-specific survival. More prospective work is needed to examine the impact of age on tumour biology and cancer-specific survival.