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Postoperative complications and short-term oncological outcomes of patients aged ≥80years undergoing robot-assisted radical cystectomy

Nguyen, Daniel ; Awamlh, Bashir ; Charles Osterberg, E. ; Chrystal, James ; Flynn, Thomas ; Lee, Daniel ; Scherr, Douglas

In: World Journal of Urology, 2015, vol. 33, no. 9, p. 1315-1321

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    Titre
    • Postoperative complications and short-term oncological outcomes of patients aged ≥80years undergoing robot-assisted radical cystectomy
    Auteur
    • Nguyen, Daniel. Department of Urology, Weill Cornell Medical College, New York Presbyterian Hospital, 525 E 68th St, 10021, New York, NY, USA
    • Awamlh, Bashir. Department of Urology, Weill Cornell Medical College, New York Presbyterian Hospital, 525 E 68th St, 10021, New York, NY, USA
    • Charles Osterberg, E.. Department of Urology, Weill Cornell Medical College, New York Presbyterian Hospital, 525 E 68th St, 10021, New York, NY, USA
    • Chrystal, James. Department of Urology, Weill Cornell Medical College, New York Presbyterian Hospital, 525 E 68th St, 10021, New York, NY, USA
    • Flynn, Thomas. Department of Urology, Weill Cornell Medical College, New York Presbyterian Hospital, 525 E 68th St, 10021, New York, NY, USA
    • Lee, Daniel. Department of Urology, Weill Cornell Medical College, New York Presbyterian Hospital, 525 E 68th St, 10021, New York, NY, USA
    • Scherr, Douglas. Department of Urology, Weill Cornell Medical College, New York Presbyterian Hospital, 525 E 68th St, 10021, New York, NY, USA
    Type de document
    • Postprint
    Langue
    • Anglais
    Publié dans
    • World Journal of Urology, 2015, vol. 33, no. 9, p. 1315-1321. Springer Berlin Heidelberg
    Autre version électronique
    Identifiant OAI-PMH
    • oai:doc.rero.ch:330984
    Summary
    Purpose: To assess complication rates and early oncological outcomes of patients aged ≥80years who underwent robot-assisted radical cystectomy (RARC). Methods: A total of 368 consecutive patients underwent radical cystectomy from April 2001 to September 2013 in a tertiary referral center. Sixty-one patients aged ≥80years underwent RARC and constitute the cohort of interest. Complications arising within 30 and 90days of surgery were graded using the modified Clavien classification and were additionally categorized by organ system using a standardized complication reporting system. Recurrence-free survival, disease-specific survival and overall survival were calculated using Kaplan-Meier curves. Results: Median age was 83years (range 80-94). Twenty-nine (48%) of all tumor specimens were stage ≥pT3. The median number of nodes removed was 19 (range 6-67). The soft tissue positive margin rate was 10%. A total of 27 (44%) patients had complications within 90days, of which 9 had major complications. Two patients (3%) died from surgical complications within 90days. At a median follow-up of 13months, 12 (20%) patients had developed recurrent cancer and subsequently died from disease. An additional 13 (21%) patients died from non-cancer-related causes. The median overall survival time was 36.0months. At 2years, recurrence-free, cancer-specific and overall survival rates were 73, 74 and 61%, respectively. Conclusions: In patients aged ≥80years, RARC is feasible with acceptable perioperative morbidity and favorable short-term oncological outcomes. Therefore, RARC should be considered a valid option for carefully selected patients aged ≥80years with bladder cancer.