RESULTS OF RADICAL CYSTPROSTATVESICULECTOMY IN OLD PATIENTS

Abstract

Abstract. As a result of rising life expectancy the indication for radical cystectomy is registered more and more frequently also in elderly and multimorbid patients. This work is aimed to estimate the importance of cystectomy in patients older than 70 years. The study was designed as a comparative analysis of two patients groups of 70-75 (group I) and over 75 (group II) years old with respect to following parameters: preoperative morbidity (Charlson Comorbidity-index), stat. length of hospital stay, transfusion rate, early and late complications, mortality and postoperative life expectancy. The data revealed that patients over 75 years old, who were higher cardiopulmonary preloaded, had a longer hospital stay and exhibited a higher transfusion rate. The early and late complication rates, assessed with the Clavien-Dindo classification, were identical in both groups. At the same time the internal medicine and major complications (CDC 3-5) dominated in the group of over 75 years old patients. The younger patients lived twice as long as the older patients. While having the same 30 days mortality in both groups, the 90 days mortality was higher in the older group. The 5-year survival was significantly higher in the group I. Thus, the radical cystectomy should be strived in older age expecting acceptable higher complication rates and mortality even in multi-morbid patients after more accurately risk stratification and evaluation of individual biological constellation.

Keywords

• bladder cancer
• age
• cystectomy
• comorbidity