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Perioperative morbidity and mortality of octogenarians treated by radical cystectomy : a multi-institutional retrospective study in Japan
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| Title: | Perioperative morbidity and mortality of octogenarians treated by radical cystectomy : a multi-institutional retrospective study in Japan |
| Authors: | Abe, Takashige Browse this author →KAKEN DB | | Takada, Norikata Browse this author | | Kikuchi, Hiroshi Browse this author | | Matsumoto, Ryuji Browse this author | | Osawa, Takahiro Browse this author | | Murai, Sachiyo Browse this author | | Miyajima, Naoto Browse this author | | Maruyama, Satoru Browse this author →KAKEN DB | | Shinohara, Nobuo Browse this author →KAKEN DB |
| Keywords: | octogenarian | | complication | | radical cystectomy | | morbidity | | mortality |
| Issue Date: | Aug-2017 |
| Publisher: | Oxford University Press |
| Journal Title: | Japanese journal of clinical oncology |
| Volume: | 47 |
| Issue: | 8 |
| Start Page: | 755 |
| End Page: | 761 |
| Publisher DOI: | 10.1093/jjco/hyx062 |
| 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. |
| Rights: | http://creativecommons.org/licenses/by-nc/4.0/ |
| Type: | article |
| URI: | http://hdl.handle.net/2115/67313 |
| Appears in Collections: | 北海道大学病院 (Hokkaido University Hospital) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)
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Submitter: 安部 崇重
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