Perioperative morbidity and mortality of octogenarians treated by radical cystectomy : a multi-institutional retrospective study in Japan

Abe, Takashige; Takada, Norikata; Kikuchi, Hiroshi; Matsumoto, Ryuji; Osawa, Takahiro; Murai, Sachiyo; Miyajima, Naoto; Maruyama, Satoru; Shinohara, Nobuo

Perioperative morbidity and mortality of octogenarians treated by radical cystectomy : a multi-institutional retrospective study in Japan

Abe, Takashige; Takada, Norikata; Kikuchi, Hiroshi et al.

Japanese journal of clinical oncology, 2017, 47(8), 755-761

Permalink : https://hdl.handle.net/2115/67313

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アクセス権	open access
URI	https://hdl.handle.net/2115/67313
タイトル	Perioperative morbidity and mortality of octogenarians treated by radical cystectomy : a multi-institutional retrospective study in Japan
著者	Abe, Takashige ; Takada, Norikata ; Kikuchi, Hiroshi ; Matsumoto, Ryuji ; Osawa, Takahiro ; Murai, Sachiyo ; Miyajima, Naoto ; Maruyama, Satoru ; Shinohara, Nobuo
e-Rad_Researcher 10399842 著者名 Abe, Takashige
著者名 Takada, Norikata
著者名 Kikuchi, Hiroshi
著者名 Matsumoto, Ryuji
著者名 Osawa, Takahiro
著者名 Murai, Sachiyo
著者名 Miyajima, Naoto
e-Rad_Researcher 80507591 著者名 Maruyama, Satoru
e-Rad_Researcher 90250422 著者名 Shinohara, Nobuo
言語	英語
キーワード	octogenarian
	complication
	radical cystectomy
	morbidity
	mortality
発行日	2017-08
出版者	Oxford University Press
収録物名	Japanese journal of clinical oncology
巻(号)	47(8)
ページ	755-761
抄録	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.
資源タイプ	学術雑誌論文
出版タイプ	Version of Record
権利情報	Creative Commons Attribution-NonCommercial 4.0 International
PISSN	0368-2811
関連情報 (isIdenticalTo)	出版社版DOI https://doi.org/10.1093/jjco/hyx062