MP15-16 THE ASSOCIATION OF AGE WITH PERIOPERATIVE AND CLINICOPATHOLOGIC OUTCOMES FOLLOWING RADICAL CYSTECTOMY FOR NON-MUSCLE INVASIVE BLADDER CANCER

You have accessJournal of UrologyBladder Cancer: Non-invasive I1 Apr 2017MP15-16 THE ASSOCIATION OF AGE WITH PERIOPERATIVE AND CLINICOPATHOLOGIC OUTCOMES FOLLOWING RADICAL CYSTECTOMY FOR NON-MUSCLE INVASIVE BLADDER CANCER William Parker, Woodson Smelser, Igor Frank, Jeffrey Holzbeierlein, Prabin Thapa, Tomas Griebling, R. Jeffrey Karnes, R. Houston Thompson, Matthew Tollefson, Eugene Lee, and Stephen Boorjian William ParkerWilliam Parker More articles by this author , Woodson SmelserWoodson Smelser More articles by this author , Igor FrankIgor Frank More articles by this author , Jeffrey HolzbeierleinJeffrey Holzbeierlein More articles by this author , Prabin ThapaPrabin Thapa More articles by this author , Tomas GrieblingTomas Griebling More articles by this author , R. Jeffrey KarnesR. Jeffrey Karnes More articles by this author , R. Houston ThompsonR. Houston Thompson More articles by this author , Matthew TollefsonMatthew Tollefson More articles by this author , Eugene LeeEugene Lee More articles by this author , and Stephen BoorjianStephen Boorjian More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2017.02.501AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Radical cystectomy (RC) remains underutilized in patients with non-muscle invasive bladder cancer (NMIBC), particularly elderly patients, despite data demonstrating inferior survival for patients with NMIBC who experience disease progression. We evaluated the association of age with perioperative and oncologic outcomes after RC for NMIBC. METHODS Multi-institutional review of patients with NMIBC managed with RC between 2000-2013. Patients were stratified by age: <70 versus ≥70. Associations of age with receipt of perioperative blood transfusion (PBT), prolonged operative time (≥75th%; pORT) and length of stay (≥75th%; pLOS), pathology at RC, and 30/90 day complications were assessed using multivariable logistic regression. Recurrence-free (RFS), cancer-specific (CSS), and overall survival (OS) were evaluated using the Kaplan-Meier method, multivariable Cox proportional hazards regression models, and competing risks models. RESULTS A total of 489 patients were identified, of whom 263 (55.8%) were <70 and 226 (46.2%) were ≥70. On multivariable analysis, age ≥70 was not significantly associated with patients' risk of receipt of a PBT, pORT, pathologic stage pT2-4 or pN+, 30 day or 90 day grade III+ complications (all p>0.05). pLOS was more likely in older patients (OR 1.77; 95%CI 1.09-2.85; p=0.02). Estimated 5-yr RFS, CSS, and OS in patients <70 versus ≥70 was 70% vs 62% (p=0.14), 84% vs 77% (p=0.06), and 74% vs 54% (p<0.01). On multivariable Cox regression analyses, age ≥70 was not independently associated with RFS (HR 1.10; 95% CI 0.79-1.52; p=0.57) or CSS (HR 1.22; 95% CI 0.82-1.82; p=0.32), but remained associated with decreased OS (HR 1.91; 95% CI 1.50-2.45; p<0.01). Moreover, among all patients and as stratified by age, pathologic upstaging was associated with worse RFS, CSS, and OS on both multivariable Cox proportional hazards regression and in competing risk (of non-cancer death) models (Table). CONCLUSIONS Older patients with NMIBC had similar risks of pathologic upstaging at RC, and patients upstaged at surgery had inferior cancer outcomes across age strata. Meanwhile, advanced age was not associated with increased risks of PBT, pORT, or perioperative complications. These data support the use of RC for select older patients with high-risk NMIBC. © 2017FiguresReferencesRelatedDetails Volume 197Issue 4SApril 2017Page: e176-e177 Advertisement Copyright & Permissions© 2017MetricsAuthor Information William Parker More articles by this author Woodson Smelser More articles by this author Igor Frank More articles by this author Jeffrey Holzbeierlein More articles by this author Prabin Thapa More articles by this author Tomas Griebling More articles by this author R. Jeffrey Karnes More articles by this author R. Houston Thompson More articles by this author Matthew Tollefson More articles by this author Eugene Lee More articles by this author Stephen Boorjian More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...