Radical cystectomy in the elderly – Is this a safe treatment option?

Peer review under responsibility of Arab Association of Urology.

Figures & data

Table 1 Surgical procedure performed, duration of procedure, intraoperative blood loss and indications for RC.

Variable	Group A, <75 years, n	Group B, ≥75 years, n	P^*
Number of patients	51	30
Laparoscopic RC	40	24
Laparoscopic converted to open RC	1	3
Open RC	10	3
Duration of procedure, h			0.54
<3	1	1
3–5	43	27
>5	7	2
Blood loss, mL			0.95
<300	22	15
300–500	13	7
500–1000	13	7
>1000	3	1
MIBC	22	14
NMIBC refractory to intravesical treatment	10	5
High-grade NMIBC	15	9
Salvage after radiotherapy	2	1
Other cancers	1	1

* Fisher’s exact test.

Table 2 Final histology TNM stage for patients undergoing RC differentiated by age.

TNM staging	Group A, <75 years (n  = 51), n (%)	Group B, ≥75 years (n  = 30), n (%)	P^*
≤T1	29 (57)	14 (47)	0.19
T2	3 (6)	2 (7)	0.5
T3	15 (29)	11 (36)	0.23
T4	4 (8)	3 (10)	0.41
N0	44 (86)	24 (80)	0.34
≥N1	7 (14)	6 (20)	0.19

* Fisher’s exact test.

Table 3 Preoperative Charlson score and CPEX anaerobic threshold results for both cohorts of patients.

Variable	Group A, <75 years (n  = 51), n (%)	Group B, ≥75 years (n  = 30), n (%)	P^*
Charlson score
0	34 (67)	14 (47)	0.10
1	10 (20)	9 (30)	0.29
2	5 (10)	4 (13)	0.72
3	1 (2)	3 (10)	0.14
≥4	1 (2)	0	n/a
CPEX anaerobic threshold, mL/kg/min
<11	15 (29)	7 (23)
≥11	36 (71)	23 (77)

* Fisher’s exact test.

Fig. 1 LOS after RC for patients aged <75 (blue) and ≥75 (red) years.

Table 4 Perioperative complications rates classified by Clavien–Dindo classification and blood transfusion rates for both cohorts of patients.

Variable	Group A, <75 years (n  = 51), n (%)	Group B, ≥75 years (n  = 30), n (%)	P^*
Clavien–Dindo classification
Nil	22 (43)	10 (33)	0.48
Minor, Grade I–II	26 (51)	16 (53)	0.97
Major, Grade III–V	3 (6)	4 (13)	0.41
Blood transfusion
Nil	43 (84)	27 (90)	0.74
Minor, 1–2 units	7 (14)	3 (10)	0.73
Major, >2 units	1 (2)	0	n/a

* Fisher’s exact test.