title: [Advanced bladder cancer in elderly patients. Prognostic outcomes and therapeutic strategies].
abstract: BACKGROUND
  Age is suggested to be the greatest single risk factor for developing urothelial carcinoma of the bladder (UCB). This review presents an overview of the incidence, prognosis, surgical and medical therapy of UCB in elderly patients (> 65 years).
  
  
  RESULTS
  Elderly patients have an approximate 11-fold increase in the incidence and a 15-fold increase in UCB mortality when compared to younger individuals. However, adequate surgical or medical treatment is less often or delayed offered to elderly patients. In properly selected cases, similar surgical outcomes and complication rates are reported in elderly patients, regardless of the type of urinary diversion. Application of perioperative systemic chemotherapy is dependent on physiologic deterioration and comorbidities. An adequate, restrictive case selection and early proactive postoperative rehabilitation are important factors to achieve good results.
  
  
  CONCLUSIONS
  In adequately selected elderly patients, radical cystectomy and urinary diversion as well as systemic chemotherapy are feasible, safe and efficacious treatment options for advanced UCB.
authors.affiliation: Klinik und Poliklinik für Urologie, Universitätsklinikum Hamburg-Eppendorf, Martinistraße 52, 20246 Hamburg. mrink@uke.uni-hamburg.de
authors.forename: M
authors.initials: M
authors.lastname: Rink
authors.forename: F K
authors.initials: FK
authors.lastname: Chun
authors.forename: T F
authors.initials: TF
authors.lastname: Chromecki
authors.forename: H
authors.initials: H
authors.lastname: Fajkovic
authors.forename: R
authors.initials: R
authors.lastname: Dahlem
authors.forename: M
authors.initials: M
authors.lastname: Fisch
authors.forename: S F
authors.initials: SF
authors.lastname: Shariat
mesh_terms: D000970:Antineoplastic Agents / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D015653:Cystectomy / Q000401:mortality*; D006801:Humans; D018579:Patient Selection; D015995:Prevalence; D011379:Prognosis; D018570:Risk Assessment; D016019:Survival Analysis; D015996:Survival Rate; D016896:Treatment Outcome; D001749:Urinary Bladder Neoplasms / Q000175:diagnosis / Q000401:mortality* / Q000628:therapy*; D014547:Urinary Diversion / Q000401:mortality*
chemical_list: D000970:Antineoplastic Agents