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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
radical cystectomy
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.
Type: article
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)

Submitter: 安部 崇重

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