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World Journal of Urology
Published in: World Journal of Urology 1/2016

01-01-2016 | Topic Paper

Treatment of muscle invasive bladder cancer in the elderly: navigating the trade-offs of risk and benefit

Authors: Noam A. VanderWalde, Michelle T. Chi, Arti Hurria, Matthew D. Galsky, Matthew E. Nielsen

Published in: World Journal of Urology | Issue 1/2016

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Abstract

Purpose

Despite the fact that bladder cancer patients have the highest median age of any type of cancer, older patients with muscle invasion are often under-treated.

Methods

In this review, we report the most up to date literature on the patterns of care and treatment of older patients with muscle invasive bladder cancer. Data on under-treatment, geriatric principles, cystectomy, perioperative chemotherapy, and bladder preservation for older patients are presented and analyzed.

Conclusion

Chronologic age should not exclude patients from curative-intent therapy. Functional age as determined by geriatric assessments and multidisciplinary evaluation can help clinicians decide on the best course of treatment for individual patients. Cystectomy, perioperative chemotherapy, and curative-intent bladder preservation are reasonable options in healthy older adults. Observation should be limited to patients with extremely poor performance status and very limited life expectancy.
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Metadata
Title
Treatment of muscle invasive bladder cancer in the elderly: navigating the trade-offs of risk and benefit
Authors
Noam A. VanderWalde
Michelle T. Chi
Arti Hurria
Matthew D. Galsky
Matthew E. Nielsen
Publication date
01-01-2016
Publisher
Springer Berlin Heidelberg
Published in
World Journal of Urology / Issue 1/2016
Print ISSN: 0724-4983
Electronic ISSN: 1433-8726
DOI
https://doi.org/10.1007/s00345-015-1708-z

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