Treatment of bladder carcinoma in patients more than 80 years old

• Published in: The Journal of urology Vol. 134; no. 5; p. 889
• Main Authors: Ogawa, A, Yanagisawa, Y, Nakamoto, T, Wajiki, M, Hirabayashi, N, Nakama, M
• Format: Journal Article
• Language: English
• Published: United States 01.11.1985
• Subjects: Adenocarcinoma - mortality; Adenocarcinoma - surgery; Adenocarcinoma - therapy; Aged; Antineoplastic Agents - therapeutic use; Carcinoma, Transitional Cell - mortality; Carcinoma, Transitional Cell - surgery; Carcinoma, Transitional Cell - therapy; Combined Modality Therapy; Female; Humans; Life Expectancy; Male; Radiotherapy Dosage; Time Factors; Urinary Bladder - surgery; Urinary Bladder Neoplasms - mortality; Urinary Bladder Neoplasms - surgery; Urinary Bladder Neoplasms - therapy; Urinary Diversion
• ISSN: 0022-5347
• DOI: 10.1016/S0022-5347(17)47510-0

We reviewed 26 patients more than 80 years old with bladder carcinoma to determine if an active surgical policy is justified. Ten patients with superficial carcinoma were treated with transurethral resection; none died of cancer and half have survived 5 years. Of 16 patients with invasive carcinoma 9 underwent total cystectomy with urinary diversion and 2 underwent partial cystectomy. There was no operative mortality. Postoperative complications were not serious. Five of the 9 patients who underwent total cystectomy are alive, with a mean survival of 35 months. The 4-year crude survival rate was 50 per cent. Both patients who underwent partial cystectomy died within 2 years. One patient treated with radiotherapy alone and 1 without any treatment have survived 2 years. These results suggest that contrary to the general tendency towards conservative treatment, a curative operation is worth attempting in elderly patients with bladder carcinoma.