Use of Preoperative Performance Status and Hemoglobin Concentration to Predict Overall Survival for Patients Aged ≥ 75 Years After Radical Cystectomy for Treatment of Bladder Cancer

Overview

Journal Int J Clin Oncol

Specialty Oncology

Date 2015 Jun 17

PMID 26077140

Citations 10

Authors

Takahiko Hara

Hideyasu Matsuyama

Yoriaki Kamiryo

Shigeaki Hayashida

Norio Yamamoto

Takahito Nasu

Keiji Joko

Yoshikazu Baba

Akinobu Suga

Mitsutaka Yamamoto

Akihiko Aoki

Kimio Takai

Satoru Yoshihiro

Motohiko Konishi

Sigeru Sakano

Katsuhiko Imoto

Yasuhide Tei

Shiro Yamaguchi

Seiji Yano

Affiliations

Soon will be listed here.

Abstract

Background: The standard of care for treatment of localized muscle-invasive bladder cancer (MIBC) is radical cystectomy (RC). The patient's condition may affect management of MIBC, especially for elderly patients with more comorbid conditions and lower performance status. We retrospectively evaluated the association between clinicopathological data and outcomes for patients with bladder cancer (BCa) treated by RC. We particularly focused on elderly patients (age ≥75 years) with BCa.

Methods: We enrolled 254 patients with BCa who underwent RC and urinary diversion with or without pelvic lymph node dissection. We assessed perioperative complications and clinicopathological data affecting overall survival (OS) after RC.

Results: The incidence of complications was 34.3 %, and that of severe complications (Grade 3-5) was 16.5 %. The elderly group experienced more severe complications (P = 0.042). Median follow-up was 43.0 months (range 1.0-155.6). Five-year OS after RC was 62.7 %. OS after RC was no different for patients aged ≥75 and <75 years (P = 0.983). Multivariate analysis revealed that Eastern Cooperative Oncology Group performance status (ECOG PS) and hemoglobin (Hb) concentration were associated with all-cause mortality. Hb concentration of <12.6 g/dl was an independent predictor of a poor prognosis among elderly patients after RC for BCa. ECOG PS >1 tended to affect OS after RC in this group.

Conclusion: ECOG PS and preoperative Hb concentration were useful for prediction of clinical outcome after RC for elderly patients. This information may aid decision-making in the treatment of elderly patients with MIBC.

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