title: Radical therapy for muscle-infiltrating bladder cancer (cystectomy or radiotherapy): does age affect the final therapeutic benefit for the patient?
abstract: OBJECTIVE
  To evaluate the therapeutic outcome of radical cystectomy and radical radiotherapy in patients with T2N0M0 clinical stage bladder cancer in relation to their age.
  
  
  METHODS
  Between 1995-2006, 119 patients with clinical stage T2N0M0 bladder cancer were treated with radical radiotherapy (group A) and were divided in 2 subgroups: >70 years old (A1) and <or=70 years old (A2). Between 1998-2006, 26 patients with the same clinical stage were treated with radical cystectomy (group B) (>70 years old/B1 subgroup and <or=70 years old/B2 subgroup). The following parameters were evaluated in both groups and subgroups: therapeutic outcome (overall survival/OS, local control, development of metastases) and tolerance (side effects and complications of each method). Kaplan-Meier method and log-rank test were used for statistical analyses.
  
  
  RESULTS
  All group B patients tolerated their treatment very well, without interruptions. The 3-year OS of groups A and B was 39 and 69%, respectively (p=0.032). The 3-year OS of subgroups A1 and A2 was 37.3 and 43.3%, respectively (p=0.085). In the cystectomy group B, 3-year OS of the subgroups was the same (B1: 68.6% and B2: 69.3%; p=0.10). Local control rate for the subgroups A1, A2, B1, B2 was 43, 40, 90 and 84%, respectively. Distant metastatic rate was 14.1, 20, 7.6 and 7.4% for subgroups A1, A2, B1, B2, respectively.
  
  
  CONCLUSIONS
  The results of both therapeutic methods in both age groups seem satisfactory. Very good tolerance was also observed. It seems that if a patient is not completely suitable for radical cystectomy or radical radiotherapy age should not be considered as an exclusion factor.
authors.affiliation: Department of Urology, General Hospital of Ioannina G. Hatzikosta, University Hospital of Ioannina, Ioannina, Greece. dimikalo@gmail.com
authors.forename: D
authors.initials: D
authors.lastname: Kalogeras
authors.forename: E
authors.initials: E
authors.lastname: Lampri
authors.forename: A
authors.initials: A
authors.lastname: Goussia
authors.forename: M
authors.initials: M
authors.lastname: Bai
authors.forename: A
authors.initials: A
authors.lastname: Capizzello
authors.forename: I
authors.initials: I
authors.lastname: Tassiou
authors.forename: N E
authors.initials: NE
authors.lastname: Stavropoulos
authors.forename: P
authors.initials: P
authors.lastname: Tsekeris
mesh_terms: D000367:Age Factors; D000368:Aged; D003131:Combined Modality Therapy; D015653:Cystectomy; D018572:Disease-Free Survival; D005500:Follow-Up Studies; D006801:Humans; D019042:Muscle Neoplasms / Q000532:radiotherapy / Q000601:surgery / Q000628:therapy*; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis; D009367:Neoplasm Staging; D012189:Retrospective Studies; D016896:Treatment Outcome; D001749:Urinary Bladder Neoplasms / Q000532:radiotherapy / Q000601:surgery / Q000628:therapy*