Robot-Assisted Radical Cystectomy Safe, Feasible for Octogenarians

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WASHINGTON, D.C.—Robot-assisted radical cystectomy (RARC) is safe and feasible in octogenarians, researchers reported here at the American Urological Association 2011 annual meeting.

Although octogenarians had significantly lower overall survival, their cancer-specific survival was similar to that of patients younger than 80 years, reported investigator E. Charles Osterberg, MD, of Weill Medical Center of Cornell University in New York.

“Despite a higher prevalence of comorbidities in octogenarians, they have similar perioperative outcomes after robotic cystectomy,” Dr. Osterberg told colleagues at the American Urological Association 2011 annual meeting.

He and his colleagues studied 162 bladder cancer patients who underwent RARC by a single surgeon. Of these, 39 (24%) were aged 80 and older. The mean follow-up was 20 months for those younger than 80 and 15 months for octogenarians..

Patients aged 80 and older and those younger than 80 were similar with respect to body mass index, gender, hydronephrosis observed on computer tomography scans, prior chemotherapy or radiotherapy for previous cancer. The researchers found no between-group differences in pathologic tumor grade, stage, lymph node involvement, lymphovascular invasion, perineural invasion, and other parameters.

Moreover, the octogenarians and younger patients had similar rates of surgery related complications based on a modified Clavien score of 2 or higher. Readmission rates were similar for the two groups.

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