Researchers from the University of Michigan have reported that aggressive surgical management of bladder cancer in patients over the age of 80 may improve survival.
Bladder cancer occurs predominantly in elderly men and less frequently in women and younger men. Most bladder cancers are not diagnosed until they have become very large. As a result, bladder cancers are typically treated with surgery and in many cases, the surgery is very aggressive, or extensive, in order to remove all of the cancer. In patients 80 years old or older, the management of bladder cancer typically includes watchful waiting (7%), radiotherapy alone (1%), full or partial cystectomy (12%), and transurethral resection (79%).
Data for this study was derived from the National Cancer Institute’s Surveillance, Epidemiology, and End Results cancer registry. The researchers evaluated treatment and survival information from 13,796 patients who were diagnosed with bladder cancer. In this group, 24% were older than 80 years of age.
Patients 80 years or older were less likely to be treated with curative surgery. However, results indicate that the elderly patients who were treated with aggressive surgery consisting of a radical or partial bladder removal (cystetectomy) experienced the greatest reduction in risk of death.
The researchers concluded that elderly patients may benefit from aggressive treatment and that factors other than age should be used to identify patients (young and old) who would be better served by less aggressive management.
Reference: Hollenbeck BK, Miller DC, Taub, et al. Aggressive treatment of bladder cancer is associated with improved overall survival among patients 80 years old or older. Urology. 2004;64:292-297.