title: Laparoscopic versus open radical cystectomy for elderly patients over 75-year-old: a single center comparative analysis.
abstract: OBJECTIVE
  To explore the morbidity, mortality and oncological results of laparoscopic radical cystectomy (LRC) in the elderly patients over 75-year-old in contrast with open radical cystectomy (ORC).
  
  
  METHODS
  We analyzed 46 radical cystectomies from January 2009 to December 2013 in patients over 75-year-old in our institute, 21 patients in the LRC group and 25 in the ORC group. Demographic parameters, operative variables and perioperative outcome were retrospectively collected and analyzed between the two groups. Perioperative morbidity and mortality were categorized as early (within 90 days after surgery) or late (more than 90 days) according to the time of occurrence.
  
  
  RESULTS
  Patients in both groups had comparable preoperative characteristics. A significant longer operative time (418 vs. 337 min, p = 0.018) and less estimated blood loss (400 vs. 500 ml p = 0.038) were observed in LRC group compared with ORC group. Infection and ileus were the most common early complications after surgery. Patients underwent ORC suffered from significantly more postoperative ileus (28.0% vs. 4.8%, P = 0.038) and infection (40% vs. 9.5%, P = 0.019) than LRC group within 90 days after surgery. The mortality rate was 4.7% (1/21) and 4% (1/25) for LRC group and ORC group respectively. At a median follow-up of 21 months (range 2-61 months), the Kaplan-Meier survival curves and log-rank analysis demonstrate that there were no significant differences between the LRC and ORC groups in the 3-year overall, cancer-specific, or recurrence-free survival rates.
  
  
  CONCLUSIONS
  It is suggested that LRC should be recommended as the primary intervention to treat muscle invasive or high risk non-muscle invasive bladder cancer in elderly patients with a relative long life expectancy.
authors.affiliation: From the Department of Urology, Changhai Hospital, Second Military Medical University, Shanghai, P. R. China.
authors.forename: Shuxiong
authors.initials: S
authors.lastname: Zeng
authors.affiliation: From the Department of Urology, Changhai Hospital, Second Military Medical University, Shanghai, P. R. China.
authors.forename: Zhensheng
authors.initials: Z
authors.lastname: Zhang
authors.affiliation: From the Department of Geriatrics, Changhai Hospital, Second Military Medical University, Shanghai, P. R. China.
authors.forename: Xiaowen
authors.initials: X
authors.lastname: Yu
authors.affiliation: From the Department of Urology, Changhai Hospital, Second Military Medical University, Shanghai, P. R. China.
authors.forename: Ruixiang
authors.initials: R
authors.lastname: Song
authors.affiliation: From the Department of Urology, Changhai Hospital, Second Military Medical University, Shanghai, P. R. China.
authors.forename: Rongchao
authors.initials: R
authors.lastname: Wei
authors.affiliation: From the Department of Urology, Changhai Hospital, Second Military Medical University, Shanghai, P. R. China.
authors.forename: Junjie
authors.initials: J
authors.lastname: Zhao
authors.affiliation: From the Department of Urology, Changhai Hospital, Second Military Medical University, Shanghai, P. R. China.
authors.forename: Linhui
authors.initials: L
authors.lastname: Wang
authors.affiliation: From the Department of Urology, Changhai Hospital, Second Military Medical University, Shanghai, P. R. China.
authors.forename: Jianguo
authors.initials: J
authors.lastname: Hou
authors.affiliation: From the Department of Urology, Changhai Hospital, Second Military Medical University, Shanghai, P. R. China.
authors.forename: Yinghao
authors.initials: Y
authors.lastname: Sun
authors.affiliation: From the Department of Urology, Changhai Hospital, Second Military Medical University, Shanghai, P. R. China.
authors.forename: Chuanliang
authors.initials: C
authors.lastname: Xu
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D011183:Postoperative Complications; D012189:Retrospective Studies; D001749:Urinary Bladder Neoplasms / Q000401:mortality / Q000601:surgery*