title: Laparoscopic Radical Cystectomy in the Elderly - Results of a Single Center LRC only Series.
abstract: OBJECTIVE
  To compare outcome of laparoscopic radical cystectomy (LRC) with ileal conduit in 22 elderly (≥75 years.) versus 51 younger (< 75 years.) patients.
  
  
  METHODS
  Analysis of prospectively gathered data of a single institution LRC only series was performed. Selection bias for LRC versus non-surgical treatments was assessed with data retrieved from the Netherlands Cancer Registry.
  
  
  RESULTS
  Median age difference between LRC groups was 9.0 years (77.0 versus 68.0 years). Both groups had similar surgical indications, body mass index and gender distribution. Charlson Comorbidity Index score was 3 versus 4 in ≥50% of younger and elderly patients. Median operative time (340 versus 341 min) and estimated blood loss (< 500 versus >500mL) did not differ between groups. Median total hospital stay was 12.0 versus 14.0 days for younger and elderly patients. Grade I-II 90-d complication rate was higher for elderly patients (68 versus 43%, p=0.05). Grade III-V 90-d complication rate was equal for both groups (23 versus 29%, p=0.557). 90-d mortality rate was higher for elderly patients (14 versus 4%, p=0.157). Median follow-up was 40.0 months for younger and 57.0 months for elderly patients. Estimated overall and cancer-specific survival at 5years. was 46% versus 35% and 64% versus 64% for youn¬ger and elderly patients respectively.
  
  
  CONCLUSIONS
  Our results suggest that LRC is feasible in elderly patients, where a non¬-surgical treatment is usually favoured.
authors.affiliation: Department of Urology, Maxima Medical Center Veldhoven, Veldhoven, The Netherlands.
authors.forename: Tom J N
authors.initials: TJ
authors.lastname: Hermans
authors.affiliation: Department of Urology, Maxima Medical Center Veldhoven, Veldhoven, The Netherlands.
authors.forename: Laurent M C L
authors.initials: LM
authors.lastname: Fossion
authors.affiliation: Eindhoven Cancer Registry/Comprehensive Cancer Centre South, Eindhoven, The Netherlands.
authors.forename: Rob
authors.initials: R
authors.lastname: Verhoeven
authors.affiliation: Department of Urology, The Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands.
authors.forename: Simon
authors.initials: S
authors.lastname: Horenblas
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015653:Cystectomy / Q000009:adverse effects* / Q000379:methods / Q000401:mortality; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects* / Q000379:methods / Q000401:mortality; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures; D009017:Morbidity; D009361:Neoplasm Invasiveness; D009426:Netherlands / Q000453:epidemiology; D011183:Postoperative Complications / Q000209:etiology* / Q000401:mortality; D012189:Retrospective Studies; D016896:Treatment Outcome; D001749:Urinary Bladder Neoplasms / Q000601:surgery*
keywords: Cystectomy; Minimally Invasive Surgical Procedures; Urinary Bladder Neoplasms