A 79-year-old man was diagnosed with muscle-invasive bladder cancer during a work-up for gross hematuria.
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Decision-making regarding whether to undergo radical cystectomy in the frail elderly can be extremely complex. Harnessing data from a large cohort of patients 75 years of age and older who underwent radical cystectomy,
Morgan and colleagues constructed a predictive model to quantitate the risk of 90-day mortality following surgery.1
In addition to age, comorbidity status, and whether cystectomy was performed in the setting of muscle invasion, preoperative albumin appeared to have an important prognostic role in determining risk of death within three months of surgery.
Answer: Pre-operative albumin
This case was prepared by Alexander Kutikov, MD, of Fox Chase Cancer Center in Philadelphia.
- Morgan TM, Keegan KA, Barocas DA, et al. Predicting the probability of 90-day survival of elderly patients with bladder cancer treated with radical cystectomy. J Urol 2011;186:829-834.