The natural history of muscle-invasive bladder cancer in geriatric patients undergoing transurethral resection only: Outcome and cost
Degener S, Dreger NM, Goedde D, Dotse J, Roth S, Lefering R, Von Rundstedt FC (2021)
Publication Type: Journal article
Publication year: 2021
Journal
Book Volume: 39
Pages Range: 300.e7-300.e13
Journal Issue: 5
DOI: 10.1016/j.urolonc.2020.11.034
Abstract
Purpose: Bladder cancer is predominant in the elderly. Up to 70% of geriatric patients with muscle-invasive bladder cancer do not receive curative treatment. We analyzed the outcome of patients managed only by transurethral resection of bladder tumor (TURBT) without chemo- or radio-therapy, and performed a cost analysis of the cumulative inpatient interventions throughout the course of the disease. Methods: From 2010 to 2016 81 patients ≥75 years with de novo muscle-invasive bladder cancer who were not eligible for curative treatment options were analyzed retrospectively. All patients were treated only with TURBT. Overall survival (OS) was measured by Kaplan-Meier plots (log-rank test) and clinical parameters predicting OS by a multivariate analysis. The cost analysis was based on actual billing from the hospital provider and referenced standardized pricing in Germany for bladder cancer treatment. Results: The median age was 83 years. The OS was 11 months, the 1-year OS was 42%. In the multivariate model Charlson Comorbidity Index <8 (P = 0.016), tumor size ≤3 cm (P = 0.011), complete (T0) tumor resection (P = 0.003), normal C-reactive protein level (P = 0.010), and initial elective surgery (P = 0.035) were shown to be independent predictors of longer OS in palliative TURBT regimes. Median treatment cost for the TURBT regimen was $16,175 vs. $16,467 for a salvage radical cystectomy in this cohort. Conclusions: In a TURBT-only concept elective surgery, tumor size, Charlson Comorbidity Index, C-reactive protein level and complete TURBT are independent predictors of OS. The treatment-related cumulative cost appears to be higher in patients not managed by cystectomy.
Authors with CRIS profile
Involved external institutions
Germany (DE)How to cite
APA:
Degener, S., Dreger, N.M., Goedde, D., Dotse, J., Roth, S., Lefering, R., & Von Rundstedt, F.-C. (2021). The natural history of muscle-invasive bladder cancer in geriatric patients undergoing transurethral resection only: Outcome and cost. Urologic Oncology-Seminars and Original Investigations, 39(5), 300.e7-300.e13. https://doi.org/10.1016/j.urolonc.2020.11.034
MLA:
Degener, Stephan, et al. "The natural history of muscle-invasive bladder cancer in geriatric patients undergoing transurethral resection only: Outcome and cost." Urologic Oncology-Seminars and Original Investigations 39.5 (2021): 300.e7-300.e13.
BibTeX: Download