TY - JOUR
T1 - Perioperative mortality is significantly greater in septuagenarian and octogenarian patients treated with radical cystectomy for urothelial carcinoma of the bladder
AU - Liberman, Daniel
AU - Lughezzani, Giovanni
AU - Sun, Maxine
AU - Alasker, Ahmed
AU - Thuret, Rodolphe
AU - Abdollah, Firas
AU - Budaus, Lars
AU - Widmer, Hugues
AU - Graefen, Markus
AU - Montorsi, Francesco
AU - Shariat, Shahrokh F.
AU - Perrotte, Paul
AU - Karakiewicz, Pierre I.
N1 - Funding Information:
P. I. Karakiewicz was partially supported by the University of Montréal Urology Associates, Fonds de la Recherche en Santé du Québec , the University of Montréal Department of Surgery , and the University of Montréal Foundation .
PY - 2011/3
Y1 - 2011/3
N2 - Objectives To revisit whether the perioperative mortality differs between septuagenarian and octogenarian patients and younger patients in a large contemporary population-based cohort. The data from tertiary care centers have suggested that perioperative mortality after radical cystectomy is not considerably different in septuagenarian or octogenarian patients compared with younger patients. However, population-based data have stated otherwise. Methods From 1988 to 2006, 12 722 radical cystectomies were performed for urothelial carcinoma of the urinary bladder in 17 Surveillance, Epidemiology, and End Results registries. Of those 12 722 patients, 4480 (35.2%) were aged 70-79 years and 1439 (11.3%) were aged <80 years. Univariate and multivariate logistic regression models tested the 90-day mortality after radical cystectomy. Covariates consisted of sex, race, year of surgery, Surveillance, Epidemiology, and End Results registry, and histologic grade and stage. Results The overall 90-day mortality rate was 4% for the entire population, 2% for patients aged ≤69 years, 5.4% for septuagenarian patients, and 9.2% for octogenarian patients. In the multivariate logistic regression analyses, septuagenarian (odds ratio 2.80; P < .001) and octogenarian (odds ratio 5.02; P < .001) age increased the risk of 90-day mortality after radical cystectomy. Conclusions In the present population-based analysis, the perioperative mortality after radical cystectomy was three- and fivefold greater in the septuagenarian and octogenarian patients, respectively, which was greater than that in tertiary care centers. This information should be included in informed consent considerations.
AB - Objectives To revisit whether the perioperative mortality differs between septuagenarian and octogenarian patients and younger patients in a large contemporary population-based cohort. The data from tertiary care centers have suggested that perioperative mortality after radical cystectomy is not considerably different in septuagenarian or octogenarian patients compared with younger patients. However, population-based data have stated otherwise. Methods From 1988 to 2006, 12 722 radical cystectomies were performed for urothelial carcinoma of the urinary bladder in 17 Surveillance, Epidemiology, and End Results registries. Of those 12 722 patients, 4480 (35.2%) were aged 70-79 years and 1439 (11.3%) were aged <80 years. Univariate and multivariate logistic regression models tested the 90-day mortality after radical cystectomy. Covariates consisted of sex, race, year of surgery, Surveillance, Epidemiology, and End Results registry, and histologic grade and stage. Results The overall 90-day mortality rate was 4% for the entire population, 2% for patients aged ≤69 years, 5.4% for septuagenarian patients, and 9.2% for octogenarian patients. In the multivariate logistic regression analyses, septuagenarian (odds ratio 2.80; P < .001) and octogenarian (odds ratio 5.02; P < .001) age increased the risk of 90-day mortality after radical cystectomy. Conclusions In the present population-based analysis, the perioperative mortality after radical cystectomy was three- and fivefold greater in the septuagenarian and octogenarian patients, respectively, which was greater than that in tertiary care centers. This information should be included in informed consent considerations.
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U2 - 10.1016/j.urology.2010.07.537
DO - 10.1016/j.urology.2010.07.537
M3 - Article
C2 - 21256568
AN - SCOPUS:79952359782
SN - 0090-4295
VL - 77
SP - 660
EP - 666
JO - Urology
JF - Urology
IS - 3
ER -