Laparoscopic Radical Cystectomy in the Elderly - Results of a Single Center LRC only Series
Int. braz. j. urol; 42 (6), 2016
Publication year: 2016
ABSTRACT Objective:
To compare outcome of laparoscopic radical cystectomy (LRC) with ileal conduit in 22 elderly ( (≥75 years) versus 51 younger (<75 years) patients. patients.Materials and Methods:
Analysis of prospectively gathered data of a single institution LRC only series was performed. Selection bias for LRC versus non-surgical treatments was assessed with data retrieved from the Netherlands Cancer Registry.Results:
Median age difference between LRC groups was 9.0 years. (77.0 versus 68.0 years). Both groups had similar surgical indications, body mass index and gender distribution. Charlson Comorbidity Index score was 3 versus 4 in ≥50% of younger and elderly patients. Median operative time (340 versus 341 min) and estimated blood loss (<500 versus >500mL) did not differ between groups. Median total hospital stay was 12.0 versus 14.0 days for younger and elderly patients. Grade I-II 90-d complication rate was higher for elderly patients (68 versus 43%, p=0.05). Grade III-V 90-d complication rate was equal for both groups (23 versus 29%, p=0.557). 90-d mortality rate was higher for elderly patients (14 versus 4%, p=0.157). Median follow-up was 40.0 months for younger and 57.0 months for elderly patients. Estimated overall and cancer-specific survival at 5years. was 46% versus 35% and 64% versus 64% for younger and elderly patients respectively.Conclusions:
Our results suggest that LRC is feasible in elderly patients, where a non-surgical treatment is usually favoured.
Cistectomía/efectos adversos, Cistectomía/métodos, Cistectomía/mortalidad, Estudios de Factibilidad, Laparoscopía/efectos adversos, Laparoscopía/métodos, Laparoscopía/mortalidad, Persona de Mediana Edad, Procedimientos Quirúrgicos Mínimamente Invasivos, Morbilidad, Invasividad Neoplásica, Países Bajos/epidemiología, Complicaciones Posoperatorias/etiología, Complicaciones Posoperatorias/mortalidad, Estudios Retrospectivos, Resultado del Tratamiento, Neoplasias de la Vejiga Urinaria/cirugía