Perioperative mortality is significantly greater in septuagenarian and octogenarian patients treated with radical cystectomy for urothelial carcinoma of the bladder

Daniel Liberman, Giovanni Lughezzani, Maxine Sun, Ahmed Alasker, Rodolphe Thuret, Firas Abdollah, Lars Budaus, Hugues Widmer, Markus Graefen, Francesco Montorsi, Shahrokh F. Shariat, Paul Perrotte, Pierre I. Karakiewicz

Research output: Contribution to journalArticlepeer-review

59 Scopus citations

Abstract

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.

Original languageEnglish (US)
Pages (from-to)660-666
Number of pages7
JournalUrology
Volume77
Issue number3
DOIs
StatePublished - Mar 2011
Externally publishedYes

Bibliographical note

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 .

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