Clinical Oncology: Outcomes & Complications
Moderated Poster Session
MP18-11 - Advanced Age Does Not Predict Survival in Patients Undergoing Radical Cystectomy for Muscle-Invasive Bladder Cancer
Saturday, September 22
10:00 AM - 12:00 PM
Location: Room 253
Introduction & Objective : Given the perioperative morbidity associated with radical cystectomy (RC), alternative treatment options are considered for elderly patients with muscle-invasive bladder cancer (MIBC). We evaluated the overall (OS) and disease-free survival (DFS) of patients with MIBC who underwent RC at our institution, based on age-stratified cohorts.
Methods : We identified 344 patients who underwent RC for MIBC from January 2010 to December 2016. Cohorts were stratified by age (<60, 60-69, 70-79, and 80+). Kaplan-Meier estimated survival curves were generated for OS and DFS. Cox proportional hazards analysis was performed to identify factors that predicted survival.
Results : Estimated survival curves are provided in Figure 1. No significant differences were noted in OS (p=0.39) and DFS (p=0.25) across the various age groups. Multivariate analysis controlling for age, histology, receipt of neoadjuvant chemotherapy, and comorbidity demonstrated that pathologic stage was the strongest independent predictor of survival. For OS, HR = 11.1, 7.3, and 3.7 for T4, T3, and T2 disease (p<0.01). For DFS, HR = 20.6, 14.6, and 4.2 for T4, T3, and T2 disease (p<0.01). Importantly length of stay (p=0.39) and 30-day complication rates (p=0.14) were not significantly different among the various age groups.
Conclusions : In our experience, increasing age was not a predictor of OS or DFS for patients receiving RC for MIBC. For patients with MIBC, clinicians should not discriminatorily offer RC on the basis of advanced age.