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J Endourol. 2016 Jul;30(7):792-8. doi: 10.1089/end.2016.0050. Epub 2016 Jun 6.

Robot-Assisted Radical Cystectomy for Bladder Cancer in Octogenarians.

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1 Department of Urology, O.L.V. Hospital , Aalst, Belgium .
2 O.L.V. Vattikuti Robotic Surgery Institute , Melle, Belgium .
3 Division of Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele , Milan, Italy .
4 Urologische Klinik und Poliklinik, Klinikum der Universität München, Ludwig-Maximilians Universität München , Munich, Germany .
5 Department of Surgery, Oncology, and Gastroenterology, Urology Clinic, University of Padua , Padua, Italy .



To evaluate perioperative morbidity and mortality rate, a 3-year recurrence-free survival, and cancer-specific mortality rate in patients older than 80 years undergoing robot-assisted radical cystectomy (RARC).


We retrospectively collected data of 155 consecutive patients who received RARC for muscle-invasive or high-risk nonmuscle-invasive urothelial carcinoma of the bladder between 2003 and 2014 at a high-volume robotic center. Diversion was performed intra- or extracorporeally according to the surgeon's preferences. Complications were graded according to the Clavien-Dindo system. Logistic regression analyses were used to assess the impact of age on postoperative outcomes.


Of 155 consecutive patients, 22 (14.2%) patients were 80 years or older. Octogenarians did not significantly differ from younger patients in ASA score (p = 0.4) and Charlson comorbidity index (p = 0.4). Prevalence of any grade and high-grade complications was similar in both groups (all p ≥ 0.6). Older patients had a significantly higher pathologic tumor grade (p = 0.04) and a lower use of pelvic lymphadenectomy (p < 0.001). No perioperative mortality rate was recorded within 90 days from surgery. Elderly patients had a similar risk of 3-year oncologic recurrence after surgery compared with their younger counterparts (odds ratio [OR] 1.63; p = 0.2). Conversely, the risk of cancer-specific mortality rate was significantly higher (OR 2.78; p = 0.02).


Patients 80 years or older undergoing RARC for bladder cancer did not have a higher risk of peri- and postoperative morbidity and mortality rate and had a similar 3-year recurrence-free survival, suggesting that RARC can be safely performed in selected elderly patients by experienced surgeons.

[Indexed for MEDLINE]

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