Perioperative Outcomes and Early Survival in Octogenarians Who Underwent Radical Cystectomy for Bladder Cancer

被引:8
作者
Zattoni, Fabio [1 ]
Palumbo, Vito [2 ]
Giannarini, Gianluca [1 ]
Crestani, Alessandro [1 ]
Kungulli, Afrovita [2 ]
Novara, Giacomo [2 ]
Zattoni, Filiberto [2 ]
Ficarra, Vincenzo [3 ]
机构
[1] Acad Med Ctr Santa Maria della Misericordia, Urol Unit, Udine, Italy
[2] Univ Padua, Dept Surg & Gastrointestinal Sci, Urol Unit, Padua, Italy
[3] Univ Messina, Urol Sect, Dept Human & Paediat Pathol Gaetano Barresi, Via Consolare Valeria 1, IT-98124 Messina, Italy
关键词
Radical cystectomy; Elderly patients; Octogenarians; Perioperative complications; Overall survival; Bladder cancer; Urothelial carcinoma; Urinary diversion; COMPLICATIONS; QUALITY; AGE;
D O I
10.1159/000478990
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
Objective: To evaluate perioperative outcomes and early survival in a series of octogenarians who underwent radical cystectomy (RC) and urinary diversion for bladder cancer. Patients and Methods: We retrospectively evaluated the clinical records of 44 patients aged >= 80 years who underwent open RC and urinary diversion at 2 high-volume centers between July 2013 and December 2015. Estimated blood loss (EBL), transfusion rate, and length of hospital stay (LOS) were evaluated. Ninety-day postoperative complications were stratified according to the type of urinary diversion. Univariable analysis was performed to identify predictors of overall and major complications. Overall survival (OS) was estimated using the Kaplan-Meier method. Results: Median age was 83 years (interquartile range [IQR] 81-85). Age-adjusted Charlson score was >= 4 in 37 (84%) patients, and American Society of Anesthesiologists score was >= 3 in 34 (77%) patients. Ileal conduit (IC) was performed in 21/44 (48%) cases, cutaneous ureterostomy (CU) in 20/44 (45%), and no urinary diversion was required for 3 (7%) dialytic patients. Median EBL was 700 mL (IQR 500-1,000) and 23 (52%) patients required blood transfusion. Median LOS was 13 days (IQR 10-18). Overall complications were recorded in 29 (66%) patients, with major complications observed in 12 (27%), with death occurring in 1. No differences in complications were observed between IC and CU. The 2-year OS estimate was 62.5%. Conclusions: Open RC in octogenarians has an acceptable rate of major complications and mortality. IC should be considered a good urinary diversion in these patients. (c) 2017 S. Karger AG, Basel
引用
收藏
页码:13 / 17
页数:5
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