高齢膀胱癌患者に対する膀胱全摘除術に関する検討

Abstract

Purpose : Bladder carcinoma often occurs in the elderly. We compared the clinical results of radical cystectomy between elder and younger patients. Materials and Methods : We retrospectively reviewed the records of 59 patients who underwent radical cystectomy for bladder carcinoma between 1993 and 2006. Two groups were compared:≦75 years old (n=49) and ＞75 years old (n=10). Overall survival and disease specific survival were evaluated using Kaplan-Meier methods and a multivariate Cox model. Results : There were no significant differences in blood loss and transfusion volume during the operation. However, the operative time in the younger patients was longer than in the elderly patients (p＜0.01). The rate of complication in the elderly patients was not different from that in the younger patients (p=0.86). The 5-year disease specific survival rates for patients ≦75 and ＞75 years old were 80.1% and 42.5%, respectively (p＜0.01). The elderly did not receive adjuvant chemotherapy. Conclusions : In the current series, almost all the elderly patients tolerated radical cystectomy compared with the younger patients. Further work is needed to determine indications for radical cystectomy and to develop strategies to improve cancer control in elderly patients.