Görgel Sacit Nuri, Şefik Ertuğrul, Balcı Uğur, Özer Kutan, Girgin Cengiz, Dinçel Çetin
Department of Urology, İzmir Atatürk Training and Research Hospital, İzmir, Turkey.
Department of Urology, İzmir Katip Çelebi University, İzmir, Turkey.
Turk J Urol. 2014 Mar;40(1):9-14. doi: 10.5152/tud.2014.09735.
In this study, we aimed to investigate the relationship between age and tumor characteristics and to evaluate oncologic results after radical cystectomy in bladder cancer with respect to age.
We reviewed 460 patients retrospectively who underwent radical cystectomy. Patients were divided into two groups according to age: ≥70 (Group 1), and <70 (Group 2). We compared tumor pathological characteristics and the results of long-term follow-up in both groups. The first group included 76 (16.7%), and the second group 379 (83.3%) patients. The mean age of the patients was 73.3±3.01 years (70-85) in Group 1 and 58.3±7.47 years (34-69) in Group 2. The American Society of Anesthesiologists (ASA) score was less than three in all of the patients, and there was no risk for major surgery.
No statistically significant difference was found between groups with respect to pathological T stage (p=0.567), lymph node involvement (p=0.179), or histological grade (p=0.567). Perioperative mortality rates were 3.9, and 3.4% in groups 1 and 2, respectively (p=0.218). Perioperative complication rates were 14.7, and 17.5% for groups 1, and 2 respectively (p=0.578). Five-year disease-specific survival (DSS) rates were 57.0, and 51.6% Groups 1, and 2, respectively. The mean DSS periods were 82.05±4.88 and 71.68±8.53 months for Groups 1, and 2, respectively. Five-year overall survival rates were 43.9% for Group 1 and 45.9% for Group 2. The mean overall survival times were 54.02±8.47, and 69.25±4.97 months for Groups 1, and 2, respectively. In Cox regression analysis, tumor stage (p=0.012) and lymph node involvement (p<0.001) were significant factors that affected the survival in both groups. None of the patients received neoadjuvant radiotherapy or chemotherapy.
We found that oncological outcomes of radical cystectomy performed with the indication of bladder tumor were comparable between young and elderly. We believe that age per se should not constitute a contraindication for radical cystectomy operations.
在本研究中，我们旨在调查年龄与肿瘤特征之间的关系，并评估膀胱癌根治性膀胱切除术后不同年龄患者的肿瘤学结果。
我们回顾性分析了460例行根治性膀胱切除术的患者。根据年龄将患者分为两组：≥70岁（第1组）和<70岁（第2组）。我们比较了两组患者的肿瘤病理特征和长期随访结果。第1组有76例（16.7%）患者，第2组有379例（83.3%）患者。第1组患者的平均年龄为73.3±3.01岁（70 - 85岁），第2组为58.3±7.47岁（34 - 69岁）。所有患者的美国麻醉医师协会（ASA）评分均低于3分，无重大手术风险。
两组在病理T分期（p = 0.567）、淋巴结受累情况（p = 0.179）或组织学分级（p = 0.567）方面均未发现统计学上的显著差异。第1组和第2组的围手术期死亡率分别为3.9%和3.4%（p = 0.218）。第1组和第2组的围手术期并发症发生率分别为14.7%和17.5%（p = 0.578）。第1组和第2组的5年疾病特异性生存率（DSS）分别为57.0%和51.6%。第1组和第2组的平均DSS时间分别为82.05±4.88个月和71.68±8.53个月。第1组的5年总生存率为43.9%，第2组为45.9%。第1组和第2组的平均总生存时间分别为54.02±8.47个月和69.25±4.97个月。在Cox回归分析中，肿瘤分期（p = 0.012）和淋巴结受累情况（p<0.001）是影响两组患者生存的重要因素。所有患者均未接受新辅助放疗或化疗。
我们发现，以膀胱肿瘤为指征进行的根治性膀胱切除术的肿瘤学结果在年轻和老年患者中具有可比性。我们认为年龄本身不应成为根治性膀胱切除术的禁忌证。
