Comploj Evi, West Jeremy, Mian Michael, Kluth Luis Alex, Karl Alexander, Dechet Christopher, Shariat Shahrokh F, Stief Christian G, Trenti Emanuela, Palermo Salvatore, Lodde Michele, Horninger Wolfgang, Madersbacher Stephan, Pycha Armin
Department of Urology, Central Hospital of Bolzano, Bolzano, Italy.
Urol Int. 2015;94(1):25-30. doi: 10.1159/000358731. Epub 2014 Jun 24.
The purpose of this study was to evaluate and compare complications after radical cystectomy in patients aged ≥75 years.
251 patients aged 75-95 years (median 79) underwent radical cystectomy between 2000 and 2012 at four institutions. The patients were divided into two groups: ≥75-84 years of age (group 1) versus ≥85 years of age (group 2). Comorbidities, body mass index, and complications were obtained retrospectively, except at the Central Hospital of Bolzano and Weill Cornell Medical Center, which collected data prospectively. Cancer-specific survival, overall mortality, hospital stay, clinical outcome and complications were assessed. Complications were categorized using the Clavien-Dindo classification reporting system. The mean follow-up was 21 months.
The median hospital stay was 17 (2-91) days. Perioperative Clavien-Dindo grade ≥III complications were seen in 24.1% (48/199) of group 1 patients and 19.2% (10/52) of group 2 patients (p = 0.045). 30- and 90-day mortality was 4.5 and 13.5% in group 1 and 6.5 and 32.3% in group 2, respectively. Only the 90-day mortality rate was statistically significant (p < 0.05) between the two groups. The 3-year overall survival was 40% in group 1 and 34% in group 2. The 3-year cancer-specific survival was 52% in group 1 and 50% in group 2.
We evaluated a large series of elderly (≥75 years) patients undergoing radical cystectomy at four institutions. Comparing patients aged ≥75-84 and ≥85 years revealed no significant difference in complications, 30-day mortality, overall and cancer-specific survival rates. Only 90-day mortality rates were significantly higher in the ≥85-year-old patients.
本研究旨在评估和比较年龄≥75岁患者根治性膀胱切除术后的并发症。
2000年至2012年期间，四家机构对251例年龄在75 - 95岁（中位年龄79岁）的患者进行了根治性膀胱切除术。患者分为两组：年龄≥75 - 84岁（第1组）与年龄≥85岁（第2组）。除博尔扎诺中央医院和威尔康奈尔医学院前瞻性收集数据外，其他机构均回顾性获取患者的合并症、体重指数和并发症情况。评估癌症特异性生存率、总死亡率、住院时间、临床结局和并发症。并发症采用Clavien - Dindo分类报告系统进行分类。平均随访时间为21个月。
中位住院时间为17（2 - 91）天。第1组患者中24.1%（48/199）出现围手术期Clavien - Dindo≥III级并发症，第2组患者中该比例为19.2%（10/52）（p = 0.045）。第1组患者30天和90天死亡率分别为4.5%和13.5%，第2组分别为6.5%和32.3%。两组间仅90天死亡率具有统计学意义（p < 0.05）。第1组3年总生存率为40%，第2组为34%。第1组3年癌症特异性生存率为52%，第2组为50%。
我们评估了四家机构中大量接受根治性膀胱切除术的老年（≥75岁）患者。比较年龄≥75 - 84岁和≥85岁的患者发现，并发症、30天死亡率、总生存率和癌症特异性生存率无显著差异。仅≥85岁患者的90天死亡率显著更高。
