IMPACT OF MALPRACTICE CAPS ON USE AND OUTCOMES OF RADICAL CYSTECTOMY FOR BLADDER CANCER: DATA FROM THE SURVEILLANCE, EPIDEMIOLOGY, AND END RESULTS PROGRAM

2005 ◽  
Vol 173 (6) ◽  
pp. 2085-2089 ◽  
Author(s):  
BADRINATH R. KONETY ◽  
VIBHU DHAWAN ◽  
VEERSATHPURUSH ALLAREDDY ◽  
SUE A. JOSLYN
Keyword(s):  
Bladder Cancer ◽  
Radical Cystectomy ◽  
Cancer Data ◽  
End Results

scholarly journals Age above 70 years and Charlson Comorbidity Index higher than 3 are associated with reduced survival probabilities after radical cystectomy for bladder cancer. Data from a contemporary series of 334 consecutive patients

2021 ◽  
Vol 93 (1) ◽  
pp. 15-20
Author(s):  
Massimo Maffezzini ◽  
Vincenzo Fontana ◽  
Andrea Pacchetti ◽  
Federico Dotta ◽  
Mattia Cerasuolo ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
Radical Cystectomy ◽  
Survival Data ◽  
Charlson Comorbidity Index ◽  
Death Rate ◽  
Joint Effect ◽  
Cancer Data ◽  
Multivariate Modelling ◽  
Comorbidity Index ◽  
Nonlinear Trends

Objective: To assess the joint effect of age and comorbidities on clinical outcomes of radical cystectomy (RC).Methods: 334 consecutive patients undergoing open RC for bladder cancer (BC) during the years 2005-2015 were analyzed. Pre-, peri- and post-operative parameters, including age at RC (ARC) and Charlson Comorbidity Index (CCI), were evaluated. Overall and cancer-specific survivals (OS, CSS) were assessed by univariate and multivariate modelling. Furthermore, a three-knot restricted cubic spline (RCS) was fitted to survival data to detect dependency between death-rate ratio (HR) and ARC. Results: Median follow-up time was 3.8 years (IQR = 1.3-7.5) while median OS was 5.9 years (95%CL = 3.8-9.1). Globally, 180 patients died in our cohort (53.8%), 112 of which (62.2%) from BC and 68 patients (37.8%) for unrelated causes. After adjusting for preoperative, pathological and perioperative parameters, patients with CCI > 3 showed significantly higher death rates (HR = 1.61; p = 0.022). The highest death rate was recorded in ARC = 71-76 years (HR = 2.25; p = 0.034). After fitting an RCS to both OS and CSS rates, two overlapping nonlinear trends, with common highest risk values included in ARC = 70-75 years, were observed. Conclusions: Age over 70 years and CCI > 3 were significant factors limiting the survival of RC and should both be considered when comparing current RC outcomes.

Predictors of the use of orthotopic bladder reconstruction after radical cystectomy for bladder cancer: data from a pilot study of 1756 cases 2004-2011

2013 ◽  
Vol 111 (7) ◽  
pp. 1061-1067 ◽  
Author(s):  
Luke S. Hounsome ◽  
Gary A. Abel ◽  
Julia Verne ◽  
David E. Neal ◽  
Georgios Lyratzopoulos
Keyword(s):  
Bladder Cancer ◽  
Pilot Study ◽  
Radical Cystectomy ◽  
Cancer Data ◽  
Bladder Reconstruction

Clinical-pathologic stage discrepancy in patients with bladder cancer treated with radical cystectomy: Associations with clinical variables and survival.

2013 ◽  
Vol 31 (6_suppl) ◽  
pp. 248-248 ◽  
Author(s):  
Phillip J. Gray ◽  
Stacey A. Fedewa ◽  
William U. Shipley ◽  
Chun Chieh Lin ◽  
Katherine S. Virgo ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
Lymph Nodes ◽  
Radical Cystectomy ◽  
Proportional Hazards Model ◽  
The Elderly ◽  
The United States ◽  
Cox Proportional Hazards Model ◽  
Extended Lymphadenectomy ◽  
Cancer Data ◽  
Pathologic Stage

248 Background: Radical cystectomy (RC) is the most common treatment for bladder cancer (BC) in the United States. We examined clinical-pathologic stage discrepancy using the National Cancer Data Base. Methods: 16,953 patients with BC treated with RC between 1998 and 2009 were analyzed. Clinical factors associated with stage discrepancy were assessed by multivariable generalized estimating equation models. Survival analysis was conducted for patients treated between 1998 and 2004 (N=7,270) using a Cox proportional hazards model. Results: 41.9% of patients were upstaged at RC while 5.9% were downstaged. Upstaging was more common in females (OR 1.08, p=.04), the elderly (OR 1.26 for age ≥80 vs. 18-59, p=.001), higher tumor grade (OR 2.29 for grade 3-4 vs. grade 1, p<.0001), non-urothelial histology (OR 1.31, p=.002 for squamous and OR 1.26, p=.03 for adenocarcinoma), and with extended lymphadenectomy (OR 1.27 for ≥10 lymph nodes examined vs. 0-9, p<.0001). Downstaging was less common in the elderly (OR 0.50 for age ≥80 vs. 18-59, p<.0001), in Hispanics (OR 0.58, p=.009) and with variant histology (OR 0.55, p=.003 for squamous and OR 0.3, p<.0001 for adenocarcinoma). Receipt of neoadjuvant chemotherapy (CT) was highly associated with downstaging (OR 2.31, p<.0001). 5-year survival by stage is shown in the table. Upstaging was associated with increased 5-year mortality (HR 1.79, p<.0001) as was receipt of CT (HR 1.28, p=.02 for neoadjuvant and HR 1.23, p<.0001 for adjuvant). Extended lymphadenectomy was associated with decreased 5-year mortality (HR 0.82 for ≥10 lymph nodes examined vs. 0-9, p<.0001). Downstaging was not associated with survival (HR 0.88, p=0.17). Conclusions: This study is the largest to date to analyze stage discrepancy and survival in BC patients treated with RC. Upstaging is common and is associated with decreased 5-year survival. These data can be used in pre-operative risk stratification, treatment decision making and comparison with studies of non-operative management. [Table: see text]

Association of age with utilization of radical cystectomy for high-grade nonmuscle invasive bladder cancer: Results from the National Cancer Database.

2017 ◽  
Vol 35 (6_suppl) ◽  
pp. 312-312
Author(s):  
William P. Parker ◽  
Harras B. Zaid ◽  
Elizabeth B. Habermann ◽  
Igor Frank ◽  
Robert Houston Thompson ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
Radical Cystectomy ◽  
Older Patients ◽  
Multivariable Analysis ◽  
Age Groups ◽  
Invasive Bladder Cancer ◽  
Intravesical Therapy ◽  
Rank Test ◽  
High Grade ◽  
Cancer Data

312 Background: Radical cystectomy (RC) is a preferred option for high−grade non−muscle invasive bladder cancer (HG NMIBC), particularly after failure of intravesical therapy. However, clinicians may be reluctant to offer surgery to older patients with NMIBC given concerns regarding morbidity. We therefore sought to evaluate the association of age with use of RC and clinicopathologic outcomes after RC for HG NMIBC. Methods: The National Cancer Data Base was queried to identify patients diagnosed with HG NMIBC between 2004−2013. Patients were stratified according to age at diagnosis: <60, 61−70, 71−80, >80 years. Multivariable logistic regression was performed to assess the associations of age group with utilization of RC and with pathologic upstaging (pT2−4 or pN+). Overall survival (OS) was evaluated using unadjusted and inverse propensity score weighted (IPTW) Kaplan−Meier methods and compared with the log-rank test. Results: RC was performed in 3,641 (5.7%) of 63,402 patients with HG NMIBC. Utilization of RC remained relatively constant over the study period (4.3%−6.8%; p=0.44). On multivariable analysis, increasing age was inversely associated with RC utilization, with the lowest utilization in those >80 (2.1% rate; OR 0.24; p<0.01). Similar associations of age with RC were observed at high volume centers (> 15 cases/year), academic centers, and for patients with cT1 disease. Among patients who underwent RC, pathologic upstaging was identified in 1,445 (43.6%), and no significant association was noted with age. NMIBC pathologic tumor stage was associated with improved OS compared to progression to pT2−4 or N+ disease at RC for all age groups: median OS improvement not reached in those under 60; 32 months in those 61−70; 55 months in those 71−80; and 34 months in those over 80 (all p<0.01). Similar improvements in survival were noted after IPTW. Conclusions: Older patients are significantly less likely to receive RC for HG NMIBC, despite a similar risk of upstaging and an improved survival when pathologic NMIBC is found at RC. These data support the use of RC for HG NMIBC in well selected patients across age strata.

238: Combined Effect of Apoptotic Biomarkers on Bladder Cancer Recurrence and Mortality after Radical Cystectomy

2007 ◽  
Vol 177 (4S) ◽  
pp. 79-80
Author(s):  
Jose A. Karam ◽  
Yair Lotan ◽  
Raheela Ashfaq ◽  
Claus G. Roehrborn ◽  
Arthur I. Sagalowsky ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
Radical Cystectomy ◽  
Cancer Recurrence ◽  
Combined Effect ◽  
Bladder Cancer Recurrence
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