title: Comparison of radical cystectomy with conservative treatment in geriatric (≥80) patients with muscle-invasive bladder cancer.
abstract: BACKGROUND
  The aim of this study was to compare overall survival in elderly patients (≥ 80 years) with muscle-invasive bladder cancer (MIBC) undergoing either radical cystectomy (RC) or conservative treatment.
  
  
  METHODS
  We performed a retrospective, comparative analysis of overall- and cancer-specific survival in octagenarians with MIBC (≥ pT2) submitted to RC or conservative treatment. Uni- and multivariable Cox regression analysis were performed to assess predictors of overall survival. Cumulative hospital stay was also analyzed for all patients.
  
  
  RESULTS
  The RC-group consisted of 33 patients with a mean age of 82.3 years (IQR 80.4-85.4 years) and the bladder preservation a cohort of 35 patients aged 83.8 years (IQR 81.8-88.2 years). No difference was detectable for overall survival (15.9 months versus 9.5 months; p = 0.18) and cancer-specific survival (23.5 months versus 19.5 months p = 0.71) or 90-day mortality (6.1% versus 14.3%; p = 0.43) between the two groups. Patients who received conservative treatment had a shorter cumulative length of hospital stay (p = 0.001). Age at the time of transurethral resection of the bladder (TUR-B) was an independent predictor of the overall survival (p = 0.004).
  
  
  CONCLUSIONS
  In this retrospective study, no clear survival benefit was observed for patients ≥80 years submitted either to radical cystectomy or conservative treatment. There was however a trend favoring radical cystectomy but this did not approach statistical significance. Octagenarians that underwent RC however spent more of their remaining lifetime in the hospital than those treated conservatively.
authors.affiliation: Department of Urology, Central Hospital of Bolzano, Italy.
authors.forename: Thomas
authors.initials: T
authors.lastname: Martini
authors.forename: Roman
authors.initials: R
authors.lastname: Mayr
authors.forename: Clemens
authors.initials: C
authors.lastname: Wehrberger
authors.forename: Christopher
authors.initials: C
authors.lastname: Dechet
authors.forename: Michele
authors.initials: M
authors.lastname: Lodde
authors.forename: Salvatore
authors.initials: S
authors.lastname: Palermo
authors.forename: Emanuela
authors.initials: E
authors.lastname: Trenti
authors.forename: Evi
authors.initials: E
authors.lastname: Comploj
authors.forename: Armin
authors.initials: A
authors.lastname: Pycha
authors.forename: Stephan
authors.initials: S
authors.lastname: Madersbacher
mesh_terms: D000367:Age Factors; D000369:Aged, 80 and over; D002277:Carcinoma / Q000188:drug therapy* / Q000401:mortality / Q000601:surgery*; D015653:Cystectomy / Q000379:methods* / Q000401:mortality; D005260:Female; D006801:Humans; D007558:Italy; D007902:Length of Stay; D008297:Male; D009361:Neoplasm Invasiveness; D012189:Retrospective Studies; D016019:Survival Analysis; D013997:Time Factors; D016896:Treatment Outcome; D001749:Urinary Bladder Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000601:surgery*