Validity and Safety of Robot-Assisted Laparoscopic Radical Cystectomy for the Elderly: Results of Perioperative Outcomes in Patients Aged ≥80 Years

Objective: To improve perioperative outcomes, robot-assisted radical cystectomy has gained increasing interest. This study aimed to assess the detailed perioperative complications of robot-assisted radical cystectomy in elderly aged >= 80 years and compare them with those of non-elderly. Material and methods: We retrospectively analyzed the clinical features of 74 patients who underwent robotassisted radical cystectomy for bladder cancer between September 2018 and September 2021. Perioperative complication was classified by the Clavien-Dindo classification and organ system-based categories. We assessed the relationship between age or Charlson comorbidity index score (>= 3 or <3) and the incidence of perioperative complication or rehospitalization rate within 90 days postoperatively. Results: Of the 74 patients, perioperative complication of all grades and grade >= IIIa occurred in 54 (73%) and 15 (20%) patients, respectively. The postoperative rehospitalization rate was 20%, and the perioperative mortality rate was 0%. Elderly (n = 20) showed no difference in the incidence of perioperative complication of all grades or grade >= IIIa compared with non-elderly, and no organ system-based category had a higher incidence in elderly than that in non-elderly. Gastrointestinal tract-related perioperative complication incidence was higher in non-elderly and those with Charlson comorbidity index >= 3 (P =.044,.039, respectively); cardiovascular-related perioperative complication incidence was higher in those with Charlson comorbidity index >= 3 (P =.0068). Conclusion: The incidence perioperative complication of robot-assisted radical cystectomy in elderly was not different from those in non-elderly, suggesting that robot-assisted radical cystectomy may be an option for the treatment of bladder cancer in elderly as well as non-elderly.