Yanagihara Yutaka, Nishida Keigo, Watanabe Ryuta, Koyama Kanae, Sawada Yuichiro, Noda Terutaka, Asai Seiji, Fukumoto Tetsuya, Miura Noriyoshi, Miyauchi Yuki, Kikugawa Tadahiko, Saika Takashi
Department of Urology, Ehime University Medical School, Toon City, Ehime 791-0245,
Department of Urology, Ehime University Medical School, Toon City, Ehime 791-0245, Japan.
Acta Med Okayama. 2019 Oct;73(5):417-418. doi: 10.18926/AMO/57371.
Laparoscopic radical cystectomy (LRC) is a standard surgical treatment for muscle-invasive bladder cancer and high-risk non-muscle-invasive bladder cancer. LRC is a less invasive modality than conventional open surgery. Therefore, even elderly patients with invasive bladder cancer may be candidates for LRC. In this study, a comparative analysis of perioperative/oncological outcomes between elderly patients and younger patients who underwent LRC was performed to assess the feasibility of LRC in elderly patients. Sixty-eight consecutive patients who underwent LRC between October 2013 and March 2018 were enrolled and stratified into those younger than 75 years (n=37) and those ≥ 75 years old (n=31). The median follow-up period was 28.2 months. The preoperative and operative parameters and complications were similar in both groups. The 2-year overall survival (OS) was 64.4% in the younger vs. 76.4% in the elderly group (p=0.053), cancer-specific survival (CSS) was 79.3% vs. 81.7% (p=0.187), and recurrence-free survival (RFS) was 58.2% vs. 75.7% (p=0.174), respectively. No significant differences were observed in OS, CSS, or RFS between the groups. No significant differences were found between the groups with respect to peri-surgical/oncological outcomes. We conclude that LRC is feasible in elderly patients.
腹腔镜根治性膀胱切除术（LRC）是肌层浸润性膀胱癌和高危非肌层浸润性膀胱癌的标准外科治疗方法。与传统开放手术相比，LRC的侵入性较小。因此，即使是患有浸润性膀胱癌的老年患者也可能适合LRC。在本研究中，对接受LRC的老年患者和年轻患者的围手术期/肿瘤学结果进行了比较分析，以评估LRC在老年患者中的可行性。纳入了2013年10月至2018年3月期间连续接受LRC的68例患者，并将其分为年龄小于75岁（n = 37）和年龄≥75岁（n = 31）两组。中位随访期为28.2个月。两组的术前和手术参数及并发症相似。年轻组的2年总生存率（OS）为64.4%，老年组为76.4%（p = 0.053）；癌症特异性生存率（CSS）分别为79.3%和81.7%（p = 0.187）；无复发生存率（RFS）分别为58.2%和75.7%（p = 0.174）。两组之间在OS、CSS或RFS方面未观察到显著差异。两组在围手术期/肿瘤学结果方面未发现显著差异。我们得出结论，LRC在老年患者中是可行的。
