Document Detail


Age and comorbidity impact surgical therapy in older bladder carcinoma patients: a population-based study.
MedLine Citation:
PMID:  16130136     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Bladder carcinoma often occurs in older patients who also may have other comorbid conditions that could influence the administration of surgical therapy. The current study was conducted to describe the distribution of comorbid conditions in patients with bladder carcinoma and ascertain whether these conditions, as grouped by the American Society of Anesthesiologists physical status classification, affected the choice of surgical therapy. METHODS: The authors examined six population-based cancer registries from the National Cancer Institute's Surveillance, Epidemiology, and End Results Program in 1992. A total of 820 individuals age 55 years and older was found. A random sample of newly diagnosed bladder carcinoma patients were stratified according to registry, age group (ages 55-64 yrs, ages 65-74 yrs, and age 75 yrs and older), and gender. Data regarding comorbid conditions were abstracted from the medical records and merged with routinely collected cancer registry data. The main outcome measures were the prevalence and distribution of comorbid conditions, American Society of Anesthesiologists physical status classification, and the receipt of cystectomy in patients with muscle invasion. RESULTS: Hypertension, chronic pulmonary disease, arthritis, and heart disease were found to affect at least 15% of the study population. Approximately 38% of patients were current or former smokers. Greater than 90% of patients with superficial disease were treated with transurethral resection alone. Among those patients with muscle invasion, only 55% of those ages 55-59 years underwent cystectomy; this percentage dropped to 4% in patients age 85 years and older. Among patients with an American Society of Anesthesiologists physical status classification of 0-2, the cystectomy rate ranged from 53% in those ages 55-59 years to 9% in those age 85 years and older. CONCLUSIONS: There were no significant treatment differences noted with regard to age among patients with superficial disease. Among those patients with muscle invasion, those age 75 years and older were less likely to undergo radical cystectomy (14%) compared with patients ages 55-64 years (48%) and those ages 65-74 years (43%). Patient age may contribute to treatment decisions in patients with muscle-invasive disease, even when comorbidity is taken into account.
Authors:
George R Prout; Margaret N Wesley; Rosemary Yancik; Lynn A G Ries; Richard J Havlik; Brenda K Edwards
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Cancer     Volume:  104     ISSN:  0008-543X     ISO Abbreviation:  Cancer     Publication Date:  2005 Oct 
Date Detail:
Created Date:  2005-10-10     Completed Date:  2006-01-12     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0374236     Medline TA:  Cancer     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1638-47     Citation Subset:  AIM; IM    
Copyright Information:
Copyright 2005 American Cancer Society
Affiliation:
Urological Services, Massachusetts General Hospital, Boston, MA, USA.
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MeSH Terms
Descriptor/Qualifier:
Adenocarcinoma / surgery
Aged
Aged, 80 and over
Aging / physiology*
Carcinoma, Squamous Cell / surgery
Carcinoma, Transitional Cell / surgery
Comorbidity*
Cystectomy
Female
Humans
Male
Middle Aged
Neoplasm Invasiveness / pathology
Neoplasm Staging
Prognosis
SEER Program
Survival Rate
Treatment Outcome
Urinary Bladder Neoplasms / surgery*
Comments/Corrections
Comment In:
Cancer. 2005 Oct 15;104(8):1559-62   [PMID:  16118803 ]
Cancer. 2005 Oct 15;104(8):1563-6   [PMID:  16116607 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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