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Objective: In this retrospective research, we aimed to evaluate the survival outcomes and survival-related prognostic factors in octogenarian (>80 years) bladder cancer patients.
Material and Methods: A total of 17 patients receiving radiotherapy or chemoradiotherapy treatment for bladder cancer in octogenarian patients were included in the study.
Results: In total 17 patients, 13 patients (76.5%) had Stage II, 2 patients (11.8.%) had Stage III and stage IVa. Median follow-up was 23 months (6-72 months).While median overall survival (OS) was 14 months, median disease-free survival (DFS) was 13 months.Overall survival and disease-free survival rates for 6 months and 1st years were 70.6%, 35% and 64.3%, 24.1%, respectively. No prognostic factors were found in the univariate Cox regression analysis for overall survival. In multivariate Cox regression analysis, we found stage (hazard ratio [HR] = 3.009. 95% confidence interval [CI] = 1.003–9.029, p = 0.049), radiotherapy doses (HR = 241,226, 95% CI = 5.421–107.679, p = 0.005) and Charlson co-morbidity index (HR = 0.161 95% CI = 0.035–0.748, p = 0.020) as independent prognostic factors for overall survival.
Conlusion: Curative radiotherapy can be used for older ( >80 years) patients with invasive bladder cancer. Nonetheless, the co-morbidity disease should be a consideration before radiotherapy and chemoradiotherapy administration
2. Zakaria AS, Santos F, Tanguay S, Kassouf W, Aprikian AG. Radical cystectomy in patients over 80 years old in Quebec: a population-based study of outcomes. J Surg Oncol. 2015;111:917–922.
3. Mak RH, Hunt D, Shipley WU, Efstathiou JA, Tester WJ, Hagan MP, et al. Long-term outcomes in patients with muscle-invasive bladder cancer after selective bladder- preserving combined-modality therapy: a pooled analysis of Radiation Therapy Oncology Group protocols 8802, 8903, 9506, 9706, 9906, 0233. J Clin Oncol 2014;32: 3801–9.
4. Lin HYD, Ye H, Krauss DJ. Muscle invasive bladder cancer survival after radical cystectomy or definitive chemoradiation: a national cancer database matched pair analysis. Int J Radiat Oncol Biol Phys 2017;99:E252.
5. Sundararajan V, Henderson T, Perry C, Muggivan A, Quan H, Ghali WA. New ICD-10 version of the Charlson comorbidity index predicted inhospital mortality. J Clin Epidemiol 2004;57:1288–94.
6. US Department of Health and Human Services. Common Terminology Criteria for Adverse Events(CTCAE).http://evs.nci.nih.gov/ftp1/CTCAE/CTCAE_4.03_2010-06-14_QuickReference_8.5x11.pdf Date last updated: June 14, 2010.
7. Witjes JA, Compérat E, Cowan NC, Santis MD, Gakis G, Lebret T, et al.European Association of Urology: EAU guidelines on muscle-invasive and metastatic bladder cancer: summary of the 2013 guidelines. Eur Urol 2014;65:778–792.
8. Rödel C, Grabenbauer GG, Kühn R, Papadopoulus T, Dunst J, Meyer M, et al.Combined- modality treatment and selective organ preservation in invasive bladder cancer: Long-term results.J Clin Oncol 2002;20:3061-3071.
9. Hollenbeck BK, Miller DC, Taub D, Dunn RL, Underwood W 3rd, Montie JE, et al:Aggressive treatment for bladder cancer is associated with improved overall survival among patients 80 years old or older. Urology 2004; 64:292–297.
10. Fischer-Valuck BW, Rao YJ, Rudra S, Przybysz D, Germino E, Samson P, et al. Treatment patterns and overall survival outcomes of octogenarians with muscle invasive cancer of the bladder: an analysis of the National Cancer Database. J Urol. 2018;199:416–423.
11. Ha MS, Chang IH. Significance of age and comorbidity as prognostic indicators for patients with bladder cancer. Asian J Androl. 2010;12:766–774.
12. Guo CC, Czerniak B. Bladder cancer in the genomic era. Archives of Pathology and Laboratory Medicine 2019; 143(6):695–704.
13. Zhu C Z, Ting HN, Ng KH, Ong TA. A review on the accuracy of bladder cancer detection methods. Journal of Cancer 2019;10(17):4038–4044.
14. Kim WJ. Changing landscape of diagnosis and treatment of bladder cancer. Investigative and Clinical Urology 2016; 57: S1–S3.
15. Lee YT, Wu YT, Yen CC, Chang MH, Chang YH, Chung HJ, et al. Concurrent chemoradiotherapy in elderly patients with muscle-invasive bladder cancer: A single-center experience. Journal of Cancer Research and Practice 2016;3(3):73-6.
16. Hsieh CH, Chung SD, Chan PH, Lai SK, Chang HC, Hsiao CH, et al. Intensity modulated radiotherapy for elderly bladder cancer patients. Radiation Oncology 2011;6(1):75.
17. Korpics MC, Block AM, Martin B, Hentz C, Gaynor ER, Henry E, et al. Concurrent chemotherapy is associated with improved survival in elderly patients with bladder cancer undergoing radiotherapy. Cancer 2017;123(18):3524-31.
18. Turgeon GA, Souhami L, Cury FL, Faria SL, Duclos M, Sturgeon J, et al. Hypofractionated intensity modulated radiation therapy in combined modality treatment for bladder preservation in elderly patients with invasive bladder cancer. International Journal of Radiation Oncology Biology Physics 2014;88(2):326-31.