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Perioperative morbidity and mortality of octogenarians treated by radical cystectomy : a multi-institutional retrospective study in Japan

Authors :
1000010399842
Abe, Takashige
Takada, Norikata
Kikuchi, Hiroshi
Matsumoto, Ryuji
Osawa, Takahiro
Murai, Sachiyo
Miyajima, Naoto
1000080507591
Maruyama, Satoru
1000090250422
Shinohara, Nobuo
1000010399842
Abe, Takashige
Takada, Norikata
Kikuchi, Hiroshi
Matsumoto, Ryuji
Osawa, Takahiro
Murai, Sachiyo
Miyajima, Naoto
1000080507591
Maruyama, Satoru
1000090250422
Shinohara, Nobuo
Publication Year :
2017

Abstract

Objective: To determine the characteristics of 90-day morbidity and mortality after radical cystectomy in Japanese octogenarians. Methods: A retrospective multi-institutional study. We reviewed the records of 834 patients treated by open radical cystectomy between 1997 and 2010. All complications within 90 days after surgery were sorted into the 11 categories proposed by the Memorial Sloan-Kettering Cancer Center and graded according to the modified Clavien-Dindo system. We compared the characteristics of complications between >= 80-year (n = 86) and < 80-year (n = 748) groups. Multivariate regression models were used to determine the predictors of complications. Results: American Society of Anesthesiologists score III-IV was more frequent (14% vs. 6%, respectively, P < 0.0001), and ureterocutaneostomy was more frequently performed (30% vs. 21%, respectively, P = 0.0148) in the >= 80-year group compared with < 80-year group. There were no significant differences in the rates of any complication, major (Grade 3-5) complication, or 90-day mortality between the two groups (>= 80-year group: 70%, 21%, 3.5%, respectively, < 80-year group: 68%, 22%, 2%, respectively). The >= 80-year group had fewer genitourinary complications (7% vs. 16%, respectively, P = 0.0131). Multivariate regression analyses revealed that bowel-using urinary diversion (P = 0.0031) and the operative time (P = 0.0269) were significant predictors of any grade of complications, and a male sex (P = 0.0167), annual cystectomy volume (P = 0.0284) and prior cardiovascular comorbidity (P = 0.0034) were significant predictors of major complications. Conclusions: In our experience, radical cystectomy in Japanese octogenarians caused similar perioperative comorbidities. Old age as a single criterion should not be used to abandon radical cystectomy; careful preoperative assessment is mandatory.

Details

Database :
OAIster
Notes :
application/msword, application/pdf, English
Publication Type :
Electronic Resource
Accession number :
edsoai.on1378524626
Document Type :
Electronic Resource