INTRODUCTION: Age is suggested to be the greatest single risk factor for developing urothelial carcinoma of the bladder (UCB). This review presents an overview of the incidence, prognosis, surgical and medical therapy of UCB in elderly patients (> 65 years). RESULTS: Elderly patients have an approximate 11-fold increase in the incidence and a 15-fold increase in UCB mortality when compared to younger individuals. However, adequate surgical or medical treatment is less often or delayed offered to elderly patients. In properly selected cases, similar surgical outcomes and complication rates are reported in elderly patients, regardless of the type of urinary diversion. Application of perioperative systemic chemotherapy is dependent on physiologic deterioration and comorbidities. An adequate, restrictive case selection and early proactive postoperative rehabilitation are important factors to achieve good results. CONCLUSIONS: In adequately selected elderly patients, radical cystectomy and urinary diversion as well as systemic chemotherapy are feasible, safe and efficacious treatment options for advanced UCB.
INTRODUCTION: Age is suggested to be the greatest single risk factor for developing urothelial carcinoma of the bladder (UCB). This review presents an overview of the incidence, prognosis, surgical and medical therapy of UCB in elderly patients (> 65 years). RESULTS: Elderly patients have an approximate 11-fold increase in the incidence and a 15-fold increase in UCB mortality when compared to younger individuals. However, adequate surgical or medical treatment is less often or delayed offered to elderly patients. In properly selected cases, similar surgical outcomes and complication rates are reported in elderly patients, regardless of the type of urinary diversion. Application of perioperative systemic chemotherapy is dependent on physiologic deterioration and comorbidities. An adequate, restrictive case selection and early proactive postoperative rehabilitation are important factors to achieve good results. CONCLUSIONS: In adequately selected elderly patients, radical cystectomy and urinary diversion as well as systemic chemotherapy are feasible, safe and efficacious treatment options for advanced UCB.
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Authors: Brent K Hollenbeck; David C Miller; David Taub; Rodney L Dunn; Shukri F Khuri; William G Henderson; James E Montie; Willie Underwood; John T Wei Journal: J Urol Date: 2005-10 Impact factor: 7.450
Authors: M Rink; M Adam; J Hansen; F K Chun; S A Ahyai; M Remzi; T Schlomm; O Engel; R Heuer; C Eichelberg; M Fisch; R Dahlem; S F Shariat Journal: Urologe A Date: 2012-09 Impact factor: 0.639
Authors: Lars Weisbach; Roland Dahlem; Giuseppe Simone; Jens Hansen; Armin Soave; Oliver Engel; Felix K Chun; Shahrokh F Shariat; Margit Fisch; Michael Rink Journal: Int Urol Nephrol Date: 2013-07-25 Impact factor: 2.370
Authors: Deborah R Kaye; Lauren E Wilson; Melissa A Greiner; Lisa P Spees; Jessica E Pritchard; Tian Zhang; Craig E Pollack; Daniel George; Charles D Scales; Chris D Baggett; Cary P Gross; Michael S Leapman; Stephanie B Wheeler; Michaela A Dinan Journal: J Geriatr Oncol Date: 2022-02-04 Impact factor: 3.929