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Use of preoperative performance status and hemoglobin concentration to predict overall survival for patients aged ≥75 years after radical cystectomy for treatment of bladder cancer

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Abstract

Background

The standard of care for treatment of localized muscle-invasive bladder cancer (MIBC) is radical cystectomy (RC). The patient’s condition may affect management of MIBC, especially for elderly patients with more comorbid conditions and lower performance status. We retrospectively evaluated the association between clinicopathological data and outcomes for patients with bladder cancer (BCa) treated by RC. We particularly focused on elderly patients (age ≥75 years) with BCa.

Methods

We enrolled 254 patients with BCa who underwent RC and urinary diversion with or without pelvic lymph node dissection. We assessed perioperative complications and clinicopathological data affecting overall survival (OS) after RC.

Results

The incidence of complications was 34.3 %, and that of severe complications (Grade 3–5) was 16.5 %. The elderly group experienced more severe complications (P = 0.042). Median follow-up was 43.0 months (range 1.0–155.6). Five-year OS after RC was 62.7 %. OS after RC was no different for patients aged ≥75 and <75 years (P = 0.983). Multivariate analysis revealed that Eastern Cooperative Oncology Group performance status (ECOG PS) and hemoglobin (Hb) concentration were associated with all-cause mortality. Hb concentration of <12.6 g/dl was an independent predictor of a poor prognosis among elderly patients after RC for BCa. ECOG PS >1 tended to affect OS after RC in this group.

Conclusion

ECOG PS and preoperative Hb concentration were useful for prediction of clinical outcome after RC for elderly patients. This information may aid decision-making in the treatment of elderly patients with MIBC.

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Conflict of interest

The authors declare that they have no conflict of interest.

Author information

Authors and Affiliations

  1. Department of Urology, Graduate School of Medicine, Yamaguchi University, 1-1-1 Minamikogushi, Ube, Yamaguchi, 755-8505, Japan

    Takahiko Hara & Hideyasu Matsuyama

  2. Department of Urology, Masuda Red Cross Hospital, I 103-1 Otoyoshi-chou, Masuda, Shimane, 698-8501, Japan

    Takahiko Hara & Akihiko Aoki

  3. Department of Urology, Shimonoseki Saisekai Toyoura Hospital, 7-3 Kogushi, Toyoura, Shiomonoseki, Yamaguchi, 759-6302, Japan

    Yoriaki Kamiryo

  4. Department of Urology and Nephrology, Tokuyama Central Hospital, 1-1 Takada, Shunan, Yamaguchi, 745-8522, Japan

    Shigeaki Hayashida & Takahito Nasu

  5. Department of Urology, Tokuyama Medical Association Hospital, 6-28 Higashiyama, Shunan, Yamaguchi, 745-0846, Japan

    Norio Yamamoto

  6. Department of Urology, Saiseikai Yamaguchi General Hospital, 2-11 Midorimachi, Yamaguchi, Yamaguchi, 753-0078, Japan

    Keiji Joko

  7. Department of Urology, Shuto General Hospital, 1000-1 Kokaisaku, Yanai, Yamaguchi, 742-0032, Japan

    Yoshikazu Baba

  8. Department of Urology, Yamaguchi Red Cross Hospital, 53-1 Hachimanbaba, Yamaguchi, Yamaguchi, 753-8519, Japan

    Akinobu Suga

  9. Department of Urology, Yamaguchi Grand Medical Center, Hofu, 77 Osaki, Yamaguchi, 747-8511, Japan

    Mitsutaka Yamamoto

  10. Department of Urology, Saiseikai Shimonoseki General Hospital, 8-5-1 Yasuoka, Shomonoseki, Yamaguchi, 759-6603, Japan

    Kimio Takai

  11. Department of Urology, Shimonoseki City Hospital, 1-13-1 Koyo, Shimonoseki, Yamaguchi, 750-8520, Japan

    Satoru Yoshihiro

  12. Department of Urology, Shunan City Shinnanyo Hospital, 2-3-15 Miyanomae, Syunan, Yamaguchi, 746-0017, Japan

    Motohiko Konishi

  13. Department of Urology, Kokura Memorial Hospital, 3-2-1 Asano, Kokura-ku, Kitakyusyu, Fukuoka, 802-8555, Japan

    Sigeru Sakano

  14. Department of Urology, Hikari Municipal Hikari General Hospital, 2-10-1 Nijigahama, Hikari, Yamaguchi, 743-0022, Japan

    Katsuhiko Imoto

  15. Department of Urology, Kanmon Medical Center, 1-1-1 Chofusotoura-cho, Shimonoseki, Yamaguchi, 752-8510, Japan

    Yasuhide Tei

  16. Department of Urology, Shimonoseki Medical Center, 3-3-8 Kamishinchi-cho, Shimonoseki, Yamaguchi, 750-0061, Japan

    Shiro Yamaguchi

  17. Department of Urology, Ogori Daiichi General Hospital, 862-3 Ogori Shimogo, Yamaguchi, Yamaguchi, 754-0002, Japan

    Seiji Yano

Authors
  1. Takahiko Hara
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  2. Hideyasu Matsuyama
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  3. Yoriaki Kamiryo
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  4. Shigeaki Hayashida
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  5. Norio Yamamoto
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  6. Takahito Nasu
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  7. Keiji Joko
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  8. Yoshikazu Baba
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  9. Akinobu Suga
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  10. Mitsutaka Yamamoto
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  11. Akihiko Aoki
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  12. Kimio Takai
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  13. Satoru Yoshihiro
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  14. Motohiko Konishi
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  15. Sigeru Sakano
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  16. Katsuhiko Imoto
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  17. Yasuhide Tei
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  18. Shiro Yamaguchi
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  19. Seiji Yano
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Consortia

The Yamaguchi Uro-Onocology Group

Corresponding author

Correspondence to Takahiko Hara.

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Hara, T., Matsuyama, H., Kamiryo, Y. et al. Use of preoperative performance status and hemoglobin concentration to predict overall survival for patients aged ≥75 years after radical cystectomy for treatment of bladder cancer. Int J Clin Oncol 21, 139–147 (2016). https://doi.org/10.1007/s10147-015-0857-9

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  • DOI: https://doi.org/10.1007/s10147-015-0857-9

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