Radical Cystectomy Morbidity Worse in the Elderly

SAN DIEGO—Patients aged 75 years and older have higher rates of surgical morbidity and mortality after radical cystectomy for muscle-invasive bladder cancer, investigators reported at the American Urological Association annual meeting.

Chandy Ellimoottil, MD, and colleagues at Loyola University Medical Center in Maywood, Ill., used the University Health System Consortium Clinical Database to identify 24,271 patients who underwent radical cystectomy from 2002 to 2012. Of these, 6,917 (28.5%) were aged 75 years and older, and the researchers considered these patients to be elderly.

Compared with patients younger than 75 years, the elderly had a longer mean length of stay (11.4 vs. 10.1 days), mean number of intensive care unit days (3.75 vs. 3.36 days), and higher rate of at least one complication (26.2% vs. 20.4%). In addition, the elderly had a higher mortality rate (1.8% vs. 1.1%) and a higher mean total cost ($32,468 vs. $29,934). The 30-day rate, however, was lower for elderly patients (20.7% vs. 19.0%).

The investigators concluded that their findings, along with clinical outcomes, should be considered when counseling elderly patients on the risk of radical cystectomy.

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