1Division of Medical Oncology, University of Colorado School of Medicine.
2University of Colorado Cancer Center; and.
J Natl Compr Canc Netw. 2020 Jun;18(6):783-790. doi: 10.6004/jnccn.2020.7585.
Bladder cancer is an extremely common cancer that primarily affects individuals aged >65 years. In caring for patients with bladder cancer, clinicians must also consider care of older persons in general. Management of muscle-invasive bladder cancer (MIBC) involves multidisciplinary treatment planning, because curative-intent therapy includes either surgery or radiation, with consideration of the role of systemic therapy. As clinicians develop a treatment plan, considering a geriatric oncology perspective may enhance patient care and influence outcomes for this large and growing population. Similarly, treatment plan development must also consider aspects unique to an older patient population, such as altered organ function, increased comorbidity, decreased functional reserve, and perhaps altered goals of treatment. Thus a thorough evaluation inclusive of disease assessment and geriatric assessment is essential to care planning. Population-based data show that as patients with MIBC age, use of standard therapies declines. Given the complexities of coordinating a multidisciplinary care plan, as well the complexities of treating a heterogeneous and potentially vulnerable older patient population, clinicians may benefit from upfront assessments to inform and guide the process. This review highlights the unique treatment planning considerations for elderly patients diagnosed with MIBC.
膀胱癌是一种极为常见的癌症，主要影响年龄大于 65 岁的人群。在照顾膀胱癌患者时，临床医生还必须考虑到一般老年人的护理。肌层浸润性膀胱癌（MIBC）的治疗管理需要多学科治疗计划，因为有治愈意图的治疗包括手术或放疗，并考虑全身治疗的作用。随着临床医生制定治疗计划，考虑老年肿瘤学的观点可能会增强患者的护理，并影响这一庞大且不断增长的人群的治疗结果。同样，治疗计划的制定也必须考虑到老年患者群体特有的方面，如器官功能改变、合并症增加、功能储备减少，以及治疗目标的改变。因此，全面评估包括疾病评估和老年评估对于护理计划至关重要。基于人群的数据表明，随着 MIBC 患者年龄的增长，标准治疗的使用率下降。鉴于协调多学科护理计划的复杂性，以及治疗异质性和潜在脆弱的老年患者群体的复杂性，临床医生可能受益于事先评估，以告知和指导这一过程。本综述强调了诊断为 MIBC 的老年患者在治疗计划方面的独特考虑因素。
