Complications following radical cystectomy for bladder cancer in the elderly.
BACKGROUND
The incidence of bladder cancer increases with advancing age. Considering the increasing life expectancy and the increasing proportion of elderly people in the general population, radical cystectomy will be considered for a growing number of elderly patients who suffer from muscle-invasive or recurrent bladder cancer.


OBJECTIVE
This article reviews contemporary complication and mortality rates after radical cystectomy in elderly patients and the relationship between age and short-term outcome after this procedure.


METHODS
A literature review was performed using the PubMed database with combinations of the following keywords cystectomy, elderly, complications, and comorbidity. English-language articles published in the year 2000 or later were reviewed. Papers were included in this review if the authors investigated any relationship between age and complication rates with radical cystectomy for bladder cancer or if they reported complication rates stratified by age groups.


RESULTS
Perioperative morbidity and mortality are increased and continence rates after orthotopic urinary diversion are impaired in elderly patients undergoing radical cystectomy. Complications are frequent in this population, particularly when an extended postoperative period (90 d instead of 30 d) is considered.


CONCLUSIONS
Although age alone does not preclude radical cystectomy for muscle-invasive or recurrent bladder cancer or for certain types of urinary diversion, careful surveillance is required, even after the first 30 d after surgery. Excellent perioperative management may contribute to the prevention of morbidity and mortality of radical cystectomy, supplementary to the skills of the surgeon, and is probably a reason for the better perioperative results obtained in high-volume centers.
Froehner
Michael
M
Department of Urology, University Hospital Carl Gustav Carus, Technical University of Dresden, Dresden, Germany. Michael.Froehner@uniklinikum-dresden.de
Brausi
Maurizio A
MA
Herr
Harry W
HW
Muto
Giovanni
G
Studer
Urs E
UE
D000368:Aged; D000369:Aged, 80 and over; D015653:Cystectomy / Q000009:adverse effects*; D006801:Humans; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology; D001749:Urinary Bladder Neoplasms / Q000601:surgery*