Muscle invasive bladder cancer in the elderly: Treatment and prognosis in a prospective cohort study

Thomas Wright; Adam Devall; Sarah Pirrie; Lucinda Billingham; K K Cheng; Maurice Zeegers; Richard Bryan; Nicholas David James

doi:10.1200/jco.2013.31.6_suppl.275

Muscle invasive bladder cancer in the elderly: Treatment and prognosis in a prospective cohort study

Thomas Wright, Adam Devall, Sarah Pirrie, Lucinda Billingham, K K Cheng, Maurice Zeegers, Richard Bryan, Nicholas David James

Research output: Contribution to journal › Article › peer-review

Abstract

275 Background: As the prevalence of bladder cancer increases amongst the elderly, nearly 1 in 3 muscle invasive bladder cancer (MIBC) cases are in patients aged >80 years (Taylor JA, III, Kuchel GA. Nat Clin Pract Urol 2009; 6(3):135-1440). However, radical cystectomy remains as the gold standard treatment for MIBC (Yafi FA, Kassouf W. Can Urol Assoc J 2009; 3(5):409-412). In this study we examined treatment patterns and outcomes patients aged >80 years from a prospective study of bladder cancer.

METHODS: The Bladder Cancer Prognosis Programme (BCPP) is a 5 year prospective cohort study (2006-2011) with 1191 patients confirmed as having newly-diagnosed bladder cancer. Recruitment took place at 9 urological centres within the West Midlands region, UK. From this cohort we identified 67 patients aged >/=80 years with newly diagnosed MIBC. Study records include overall and disease specific survival, time to disease recurrence and radiotherapy (RT) treatment. Simple descriptive statistics were used to describe the outcomes.

RESULTS: This cohort consisted of 46 male and 21 female patients with a median age of 83 (IQR=81, 87; range=80, 94). Only 4 (6%) patients underwent cystectomy and 36 (53%) underwent RT. Median survival data is summarised in the table below.

CONCLUSIONS: Despite guidelines, practising urologists in the West Midlands region do not offer cystectomy to the vast majority of MIBC patients aged >80 years. Furthermore, in this patient cohort, OS was shorter than BCSS by 10 months, suggesting that quality of life after diagnosis will be far more important than cure rates due to deaths from other causes. Of particular note is that the group receiving RT had longer OS and BCSS than the rest of the cohort. This indicates that RT could be a far more appropriate standard of care in the elderly than surgery, which is clearly of limited applicability in this growing demographic.

CLINICAL TRIAL INFORMATION: 06/MRE04/65. [Table: see text].

Original language	English
Pages (from-to)	275
Journal	Journal of Clinical Oncology
Volume	31
Issue number	6_suppl
DOIs	https://doi.org/10.1200/jco.2013.31.6_suppl.275
Publication status	Published - 20 Feb 2013

Keywords

Journal Article

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1200/jco.2013.31.6_suppl.275

Cite this

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title = "Muscle invasive bladder cancer in the elderly: Treatment and prognosis in a prospective cohort study",

abstract = "275 Background: As the prevalence of bladder cancer increases amongst the elderly, nearly 1 in 3 muscle invasive bladder cancer (MIBC) cases are in patients aged >80 years (Taylor JA, III, Kuchel GA. Nat Clin Pract Urol 2009; 6(3):135-1440). However, radical cystectomy remains as the gold standard treatment for MIBC (Yafi FA, Kassouf W. Can Urol Assoc J 2009; 3(5):409-412). In this study we examined treatment patterns and outcomes patients aged >80 years from a prospective study of bladder cancer.METHODS: The Bladder Cancer Prognosis Programme (BCPP) is a 5 year prospective cohort study (2006-2011) with 1191 patients confirmed as having newly-diagnosed bladder cancer. Recruitment took place at 9 urological centres within the West Midlands region, UK. From this cohort we identified 67 patients aged >/=80 years with newly diagnosed MIBC. Study records include overall and disease specific survival, time to disease recurrence and radiotherapy (RT) treatment. Simple descriptive statistics were used to describe the outcomes.RESULTS: This cohort consisted of 46 male and 21 female patients with a median age of 83 (IQR=81, 87; range=80, 94). Only 4 (6%) patients underwent cystectomy and 36 (53%) underwent RT. Median survival data is summarised in the table below.CONCLUSIONS: Despite guidelines, practising urologists in the West Midlands region do not offer cystectomy to the vast majority of MIBC patients aged >80 years. Furthermore, in this patient cohort, OS was shorter than BCSS by 10 months, suggesting that quality of life after diagnosis will be far more important than cure rates due to deaths from other causes. Of particular note is that the group receiving RT had longer OS and BCSS than the rest of the cohort. This indicates that RT could be a far more appropriate standard of care in the elderly than surgery, which is clearly of limited applicability in this growing demographic.CLINICAL TRIAL INFORMATION: 06/MRE04/65. [Table: see text].",

keywords = "Journal Article",

author = "Thomas Wright and Adam Devall and Sarah Pirrie and Lucinda Billingham and Cheng, {K K} and Maurice Zeegers and Richard Bryan and James, {Nicholas David}",

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doi = "10.1200/jco.2013.31.6_suppl.275",

language = "English",

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T1 - Muscle invasive bladder cancer in the elderly

T2 - Treatment and prognosis in a prospective cohort study

AU - Wright, Thomas

AU - Devall, Adam

AU - Pirrie, Sarah

AU - Billingham, Lucinda

AU - Cheng, K K

AU - Zeegers, Maurice

AU - Bryan, Richard

AU - James, Nicholas David

PY - 2013/2/20

Y1 - 2013/2/20

N2 - 275 Background: As the prevalence of bladder cancer increases amongst the elderly, nearly 1 in 3 muscle invasive bladder cancer (MIBC) cases are in patients aged >80 years (Taylor JA, III, Kuchel GA. Nat Clin Pract Urol 2009; 6(3):135-1440). However, radical cystectomy remains as the gold standard treatment for MIBC (Yafi FA, Kassouf W. Can Urol Assoc J 2009; 3(5):409-412). In this study we examined treatment patterns and outcomes patients aged >80 years from a prospective study of bladder cancer.METHODS: The Bladder Cancer Prognosis Programme (BCPP) is a 5 year prospective cohort study (2006-2011) with 1191 patients confirmed as having newly-diagnosed bladder cancer. Recruitment took place at 9 urological centres within the West Midlands region, UK. From this cohort we identified 67 patients aged >/=80 years with newly diagnosed MIBC. Study records include overall and disease specific survival, time to disease recurrence and radiotherapy (RT) treatment. Simple descriptive statistics were used to describe the outcomes.RESULTS: This cohort consisted of 46 male and 21 female patients with a median age of 83 (IQR=81, 87; range=80, 94). Only 4 (6%) patients underwent cystectomy and 36 (53%) underwent RT. Median survival data is summarised in the table below.CONCLUSIONS: Despite guidelines, practising urologists in the West Midlands region do not offer cystectomy to the vast majority of MIBC patients aged >80 years. Furthermore, in this patient cohort, OS was shorter than BCSS by 10 months, suggesting that quality of life after diagnosis will be far more important than cure rates due to deaths from other causes. Of particular note is that the group receiving RT had longer OS and BCSS than the rest of the cohort. This indicates that RT could be a far more appropriate standard of care in the elderly than surgery, which is clearly of limited applicability in this growing demographic.CLINICAL TRIAL INFORMATION: 06/MRE04/65. [Table: see text].

AB - 275 Background: As the prevalence of bladder cancer increases amongst the elderly, nearly 1 in 3 muscle invasive bladder cancer (MIBC) cases are in patients aged >80 years (Taylor JA, III, Kuchel GA. Nat Clin Pract Urol 2009; 6(3):135-1440). However, radical cystectomy remains as the gold standard treatment for MIBC (Yafi FA, Kassouf W. Can Urol Assoc J 2009; 3(5):409-412). In this study we examined treatment patterns and outcomes patients aged >80 years from a prospective study of bladder cancer.METHODS: The Bladder Cancer Prognosis Programme (BCPP) is a 5 year prospective cohort study (2006-2011) with 1191 patients confirmed as having newly-diagnosed bladder cancer. Recruitment took place at 9 urological centres within the West Midlands region, UK. From this cohort we identified 67 patients aged >/=80 years with newly diagnosed MIBC. Study records include overall and disease specific survival, time to disease recurrence and radiotherapy (RT) treatment. Simple descriptive statistics were used to describe the outcomes.RESULTS: This cohort consisted of 46 male and 21 female patients with a median age of 83 (IQR=81, 87; range=80, 94). Only 4 (6%) patients underwent cystectomy and 36 (53%) underwent RT. Median survival data is summarised in the table below.CONCLUSIONS: Despite guidelines, practising urologists in the West Midlands region do not offer cystectomy to the vast majority of MIBC patients aged >80 years. Furthermore, in this patient cohort, OS was shorter than BCSS by 10 months, suggesting that quality of life after diagnosis will be far more important than cure rates due to deaths from other causes. Of particular note is that the group receiving RT had longer OS and BCSS than the rest of the cohort. This indicates that RT could be a far more appropriate standard of care in the elderly than surgery, which is clearly of limited applicability in this growing demographic.CLINICAL TRIAL INFORMATION: 06/MRE04/65. [Table: see text].

KW - Journal Article

U2 - 10.1200/jco.2013.31.6_suppl.275

DO - 10.1200/jco.2013.31.6_suppl.275

M3 - Article

C2 - 28136750

SN - 0732-183X

VL - 31

SP - 275

JO - Journal of Clinical Oncology

JF - Journal of Clinical Oncology

IS - 6_suppl

ER -

Muscle invasive bladder cancer in the elderly: Treatment and prognosis in a prospective cohort study

Abstract

Keywords

UN SDGs

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