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Open Access 01-01-2022 | Cystectomy | Urology - Original Paper

Clinical outcome and quality of life in octogenarian patients with muscle-invasive urothelial carcinoma of the bladder treated with radical cystectomy or transurethral resection of the bladder tumor: a retrospective analysis of 143 patients

Authors: Christian Rehme, Beatrix Fritsch, Luca Thomas, Stefan Istin, Carolin Burchert, Bastian Hummel, Bogdan Baleanu-Curaj, Henning Reis, Tibor Szarvas, Herbert Ruebben, Boris Hadaschik, Christian Niedworok

Published in: International Urology and Nephrology | Issue 1/2022

Abstract

Purpose

To compare clinical outcome and quality of life (QoL) in octogenarian patients with muscle-invasive urothelial carcinoma (MIBC) either treated by radical cystectomy (RC) or transurethral resection of the tumor (TURBT).

Methods

We identified octogenarian patients with MIBC in our institutions since 2005. Clinical treatment outcomes and QoL were analyzed. Uni- and multivariable Cox regression analyses, two-tailed Wilcoxon test, Mann–Whitney test and Fisher’s exact test were assessed as appropriate. QoL was evaluated using FACT-G (Functional Assessment of Cancer Therapy-General) questionnaire.

Results

143 patients were identified (RC: 51 cases, TURBT: 92 cases). Mean follow-up was 14 months (0–100 months). Median overall survival (OS) was 12 months in the RC group and 7 months in the TURBT group. TURBT and low preoperative hemoglobin were independent risk factors for reduced cancer-specific survival (CSS) (TURBT: p = 0.019, Hb: p = 0.008) and OS (TURBT: p = 0.026, Hb: p = 0.013) in multivariable analyses. Baseline QoL was low throughout the whole cohort. There was no difference in baseline FACT-G scoring comparing RC and TURBT (FACT-G total score (median): RC 43.7/108 vs. TURBT 44.0/108, p = 0.7144). Increased FACT-G questionnaire scoring was assessed for RC patients (median percentage score change RC 22.9%, TURBT 2.3%, p < 0.0001).

Conclusion

RC and TURBT are feasible treatment options for MIBC in octogenarian patients. In our cohort, RC was associated with increased CSS, OS and QoL. QoL in general was low throughout the whole cohort. Interdisciplinary decision-making has to be improved for these critically ill patients.

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Title: Clinical outcome and quality of life in octogenarian patients with muscle-invasive urothelial carcinoma of the bladder treated with radical cystectomy or transurethral resection of the bladder tumor: a retrospective analysis of 143 patients
Authors: Christian Rehme
Beatrix Fritsch
Luca Thomas
Stefan Istin
Carolin Burchert
Bastian Hummel
Bogdan Baleanu-Curaj
Henning Reis
Tibor Szarvas
Herbert Ruebben
Boris Hadaschik
Christian Niedworok
Publication date: 01-01-2022
Publisher: Springer Netherlands
Keywords: Cystectomy
Urothelial Cancer
Urothelial Cancer
Published in: International Urology and Nephrology / Issue 1/2022
Print ISSN: 0301-1623
Electronic ISSN: 1573-2584
DOI: https://doi.org/10.1007/s11255-021-03073-5

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