Cistectomía radical como tratamiento del cáncer vesical infiltrante en el paciente de edad avanzada

Villalba, J.A. March; Jabaloyas, J.M. Martínez; Hernández, F. Pastor; Stefan, Faulstich; Navarro, R.; Nuez, P. Chuan

doi:10.1016/s0210-4806(08)73917-2

Cited by 11 publications

(2 citation statements)

References 24 publications

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“…15 Similarly, age and cardiac disease are also independent risk factor for postoperative complication. 16 In a prospective study, patients of ASA 3 or more were found susceptible to complications. 17 There were altogether 5 (15.6%) mortality in our study when all the 32 cases were taken into consideration.…”

Section: Discussionmentioning

confidence: 99%

Perioperative outcomes after open radical cystectomy for muscle invasive bladder cancer

Shrestha

Maskey

Phuyal

et al. 2019

J Patan Acad Health Sci

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Introductions: Radical cystectomy with bilateral pelvic lymphadenectomy is a primary intervention for muscle invasive or refractory, high grade Ta, T1, Tis bladder cancer. Owing to its major undertaking, patient succumbs to infection and various morbidities. This study was to assess the perioperative outcomes and complications of radical cystectomy. Methods: This retrospective study analyzed the perioperative outcome (early mortality within 30 days, length of stay, requirement of blood transfusion) of radical cystectomy in patients with bladder cancer during four years at Patan Hospital, Patan Academy of Health Sciences, Lalitpur, Nepal. Ethical approval was obtained. Study variables included patient’s demographics, presenting symptoms, tumor types and configuration, need for blood transfusion, length of surgery, pathological stages, types of urinary diversions, hospital stay, early (<30 days) and late (31-90 days) morbidity and mortality. Results: Total 32 patients underwent radical cystectomy. Data analysed on 18 patients, mean age was 66.7 years and painless hematuria 17 (94.4%). All were transitional cell carcinoma, high grade lesion in 17 (94.4%). Overall 6 (33.3%) patients developed early postoperative complications, paralytic ileus and prolong lymph drainage in 5 (27.8%), wound dehiscence in 4 (22.2%) and ureteric catheter dislodgement in two. There were 2 (11.1% of 18) mortalities (the mortality audit showed total 5 (15.6%) out of 32 radical cystectomy during the study period. Conclusions: Perioperative complications occurred in 1/3rd following radical cystectomy for muscle invasive bladder, more complications in those with preoperative associated co-morbidities.

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Section: Discussionmentioning

confidence: 99%

Perioperative outcomes after open radical cystectomy for muscle invasive bladder cancer

Shrestha

Maskey

Phuyal

et al. 2019

J Patan Acad Health Sci

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“…Hollenbeck et al [26] also identified several independent risk factors for postoperative morbidity: age, a history of dyspnea, chronic steroid use and an ASA ≥3. Similarly, March et al [27] identified age and cardiac disease as independent risk factors for major complications. Zebic et al [16] reported ASA 4 as a significant risk factor for mortality while complications and mortality were not different between ASA 2 and ASA 3 in their series.…”

Section: Discussionmentioning

confidence: 99%

Systematic Assessment of Complications and Outcome of Radical Cystectomy Undertaken with Curative Intent in Patients with Comorbidity and over 75 Years of Age

Hakenberg

Froehner²,

Zastrow³

et al. 2013

Urol Int

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Objective: To evaluate the complications, survival and oncological outcome of patients ≥75 years of age after radical cystectomy for muscle-invasive bladder cancer. Patients and Methods: Between April 1993 and August 2010, 765 patients with muscle-invasive bladder cancer underwent radical cystectomy at one high-volume center. Of these, 70 patients were ≥75 years of age. All 70 patients had at least one severe systemic comorbidity with an American Society of Anesthesiologists score of 3. Primary endpoints of this retrospective study were overall and recurrence-free survival with a mean follow-up of 22 months (1-159). Perioperative parameters such as need for blood transfusions, hospital stay, mortality, short- and long-term complications were also assessed. Complications were graded according to the Clavien-Dindo classification. Results: Perioperative complications occurred in 23/70 patients (33%) with a 30-day mortality rate of 1.4%. 16/70 patients (23%) developed late complications requiring hospitalization. Within 30 days of surgery, according to the Clavien-Dindo grading, 27% had no complications, 3% grade 1, 49% grade 2, 14% grade 3, 6% grade 4 and 1.4% grade 5 complications. Within 31-90 days after surgery, 76% had grade 1 complications, 3% grade 2, 6% grade 3, 9% grade 4 and 6% grade 4 complications. The calculated 5- and 8-year overall survival rates were 30 and 25%, respectively, with a recurrence-free survival rate of 52% at 5 and 42% at 8 years. Conclusions: Radical cystectomy is an appropriate and effective treatment for comorbid elderly patients. The oncological long-term outcome is the same as in younger patients while overall survival is comparatively lower. Mortality and complication-related morbidity are comparable to those in younger patients with modern perioperative management.

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MIBC and Radical Cystectomy in the Elderly: A Systematic Review

Goonewardene

Ventii

Bahl

et al. 2021

Management of Urology

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Cistectomía radical como tratamiento del cáncer vesical infiltrante en el paciente de edad avanzada

Abstract: Radical cystectomy could be performed in carefully selected elderly patients.

Cited by 11 publications

References 24 publications

Perioperative outcomes after open radical cystectomy for muscle invasive bladder cancer

Perioperative outcomes after open radical cystectomy for muscle invasive bladder cancer

Systematic Assessment of Complications and Outcome of Radical Cystectomy Undertaken with Curative Intent in Patients with Comorbidity and over 75 Years of Age

MIBC and Radical Cystectomy in the Elderly: A Systematic Review

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