title: Comparison of complications from radical cystectomy between old-old versus oldest-old patients.
abstract: BACKGROUND
  The purpose of this study was to evaluate and compare complications after radical cystectomy in patients aged ≥75 years.
  
  
  METHODS
  251 patients aged 75-95 years (median 79) underwent radical cystectomy between 2000 and 2012 at four institutions. The patients were divided into two groups: ≥75-84 years of age (group 1) versus ≥85 years of age (group 2). Comorbidities, body mass index, and complications were obtained retrospectively, except at the Central Hospital of Bolzano and Weill Cornell Medical Center, which collected data prospectively. Cancer-specific survival, overall mortality, hospital stay, clinical outcome and complications were assessed. Complications were categorized using the Clavien-Dindo classification reporting system. The mean follow-up was 21 months.
  
  
  RESULTS
  The median hospital stay was 17 (2-91) days. Perioperative Clavien-Dindo grade ≥III complications were seen in 24.1% (48/199) of group 1 patients and 19.2% (10/52) of group 2 patients (p = 0.045). 30- and 90-day mortality was 4.5 and 13.5% in group 1 and 6.5 and 32.3% in group 2, respectively. Only the 90-day mortality rate was statistically significant (p < 0.05) between the two groups. The 3-year overall survival was 40% in group 1 and 34% in group 2. The 3-year cancer-specific survival was 52% in group 1 and 50% in group 2.
  
  
  CONCLUSIONS
  We evaluated a large series of elderly (≥75 years) patients undergoing radical cystectomy at four institutions. Comparing patients aged ≥75-84 and ≥85 years revealed no significant difference in complications, 30-day mortality, overall and cancer-specific survival rates. Only 90-day mortality rates were significantly higher in the ≥85-year-old patients.
authors: Department of Urology, Central Hospital of Bolzano, Bolzano, Italy.
authors: Evi
authors: E
authors: Comploj
authors: Jeremy
authors: J
authors: West
authors: Michael
authors: M
authors: Mian
authors: Luis Alex
authors: LA
authors: Kluth
authors: Alexander
authors: A
authors: Karl
authors: Christopher
authors: C
authors: Dechet
authors: Shahrokh F
authors: SF
authors: Shariat
authors: Christian G
authors: CG
authors: Stief
authors: Emanuela
authors: E
authors: Trenti
authors: Salvatore
authors: S
authors: Palermo
authors: Michele
authors: M
authors: Lodde
authors: Wolfgang
authors: W
authors: Horninger
authors: Stephan
authors: S
authors: Madersbacher
authors: Armin
authors: A
authors: Pycha
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D015897:Comorbidity; D015653:Cystectomy / Q000009:adverse effects* / Q000401:mortality; D018450:Disease Progression; D018572:Disease-Free Survival; D005060:Europe; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D007902:Length of Stay; D008297:Male; D011183:Postoperative Complications / Q000175:diagnosis / Q000209:etiology* / Q000401:mortality; D011446:Prospective Studies; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D001749:Urinary Bladder Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*