Radical Cystectomy in the Elderly Patient

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Abstract
A total of 77 patients 65 or more yr old underwent radical cystectomy with urinary diversion for invasive bladder cancer during a 10 yr interval. The preoperative medical condition of the patients, operative mortality and morbidity, and preliminary survival data are reviewed by age group. Two-thirds of the patients had previous medical or surgical problems that increased the surgical risk. The overall mortality rate was 3.9%. Early complications occurred in 31% of the patients with an increased risk of complications associated with previous illness and major pelvic surgery, and preoperative radiation therapy. The complication rate was not related directly to age, with patients 65 to 69 and > 75 yr old having lower rates than those 70-74 yr old. The 3 yr survival rate free of disease ranged from 58% in the youngest group to 39% in the oldest group, which is comparable to survival statistics for younger patients undergoing cystectomy. Only 5 patients have died of intercurrent illness; 20 died of metastatic disease.