Increased One-Year Mortality Among Elderly Patients After Radical Cystectomy for Muscle-Invasive Bladder Cancer: A Retrospective, Observational Comparative Study

Figures & data

Table 1 Baseline Patients’ Characteristics

Variable	Age (Years)		p
	<70	≥70
Totals, n (%); (n = 568)	403 (70.95)	165 (29.05)
Age – median (IQR)	62 (57–66)	74 (71.5–77)	<0.001
Sex, n (%); (n = 568)			0.963
Male	307 (76.18)	126 (76.36)
Female	96 (23.82)	39 (23.64)
Residency status			0.027
Urban	286 (70.97)	132 (80.00)
Rural	117 (29.03)	33 (20.00)
Smoking status (n = 244)			<0.001
Nonsmoker	16 (9.47)	12 (16.00)
Previous smoker	101 (59.76)	59 (78.67)
Current smoker	52 (30.77)	4 (5.33)
Time to cystectomy (n = 503)			0.418
≤90 days	218 (61.58)	86 (57.72)
>90 days	136 (38.42)	63 (42.28)
NAC, n (%); (n = 568)			0.772
No	328 (81.39)	136 (82.42)
Yes	75 (18.61)	29 (17.58)

Abbreviation: NAC, neoadjuvant chemotherapy.

Table 2 Variables Related to Radical Cystectomy

Variable	Age (Years)		p
	<70	≥70
Surgical approach, n (%); (n = 568)			0.120
Open	313 (77.67)	118 (71.52)
Laparoscopic	90 (22.33)	47 (28.48)
Urinary diversion n (%); (n = 550)			<0.001
Ureterostomy	153 (39.33)	97 (60.25)
Ileal conduit	207 (53.21)	62 (38.51)
Neobladder	29 (7.46)	2 (1.24)
PLND yield, n (%); (n = 491)			0.052
≤10	102 (28.49)	50 (37.59)
>10	256 (71.51)	83 (62.41)
Surgical margin, n (%); (n = 561)			0.114
Negative	333 (83.46)	126 (77.78)
Positive	66 (16.54)	36 (22.22)
Palliative cystectomy; (n = 568)			0.779
No	376 (93.3)	155 (93.94)
Yes	27 (6.7)	10 (6.06)
Complications, Clavien-Dindo grade			0.353
No complications + minor (grade 1–2)	301 (74.69)	117 (70.91)
Severe complications (grade 3–5)	102 (25.31)	48 (29.09)

Abbreviation: PLND, pelvic lymph node dissection.

Table 3 Pathologic Features of Bladder Cancer

Variable	Age (Years)		p
	<70	≥70
History of MIBC (n = 265)			0.004
Primary	141 (77.05)	49 (59.76)
Secondary	42 (22.95)	33 (40.24)
Pathological T stage (n = 563)			0.341
pT0	40 (10.50)	20 (12.12)
pTis/Ta/T1	49 (12.25)	12 (7.27)
pT2	71 (17.75)	24 (14.55)
pT3	129 (32.25)	60 (36.36)
pT4	109 (27.25)	49 (29.70)
Pathological N stage, n (%) (n = 565)			0.010
pN0	232 (58.00)	99 (60.00)
pN+	134 (33.50)	40 (24.24)
pNx	34 (8.50)	26 (15.76)

Abbreviation: MIBC, muscle-invasive bladder cancer.

Table 4 Short-Term Mortality Data of Entire Cohort

Variable (n=563)	Age (Years)		p
	<70	≥70
Early all-cause mortality (≤90 days)	18 (4.47)	12 (7.27)	0.175
One-year all-cause mortality	134 (33.25)	77 (46.67)	0.003

Table 5 Short-Term Mortality Data with Censoring of Palliative Cases

Variable (n = 531)	Age (years)		p
	<70	≥70
Early all-cause mortality (≤90 days)	14 (3.72)	11 (7.10)	0.095
One-year all-cause mortality	116 (30.85)	68 (43.87)	0.004

Table 6 Multivariate Stepwise Cox Regression Analysis of Individual Risk Factors Predicting One-Year All-Cause Mortality After Radical Cystectomy

	Estimate	SD	Chi-Square	HR	Lower 95% CI	Upper 95% CI	p value
Age (Ref. <70)	0.751	0.279	7.260	2.119	1.227	3.660	0.007
Residency status (Ref. Urban)	0.565	0.267	4.487	1.760	1.043	2.968	0.034
Smoking status (Ref. nonsmoker)
Previous smoker	0.203	0.389	0.272	1.225	0.572	2.625	0.602
Current smoker	0.807	0.447	3.256	2.240	0.933	5.381	0.071
History of MIBC (Ref. primary)	−0.702	0.315	4.953	0.496	0.267	0.920	0.026
Surgical approach (Ref. open)	−0.476	0.241	3.881	0.622	0.387	0.998	0.049
Pathological T stage (Ref. ≤pT2)	0.746	0.307	5.902	2.109	1.155	3.850	0.015
Pathological N stage (Ref. pN0)
pN+	0.819	0.288	8.087	2.268	1.290	3.987	0.004
pNx	1.802	0.372	23.494	6.064	2.926	12.568	<0.001

Abbreviations: CI, confidence intervals; HR, hazard ratio; SD, standard error.