TY - JOUR
T1 - Treatment of muscle invasive bladder cancer in the elderly
T2 - navigating the trade-offs of risk and benefit
AU - VanderWalde, Noam A.
AU - Chi, Michelle T.
AU - Hurria, Arti
AU - Galsky, Matthew D.
AU - Nielsen, Matthew E.
N1 - Publisher Copyright:
© 2015, Springer-Verlag Berlin Heidelberg.
PY - 2016/1/1
Y1 - 2016/1/1
N2 - Purpose: Despite the fact that bladder cancer patients have the highest median age of any type of cancer, older patients with muscle invasion are often under-treated. Methods: In this review, we report the most up to date literature on the patterns of care and treatment of older patients with muscle invasive bladder cancer. Data on under-treatment, geriatric principles, cystectomy, perioperative chemotherapy, and bladder preservation for older patients are presented and analyzed. Conclusion: Chronologic age should not exclude patients from curative-intent therapy. Functional age as determined by geriatric assessments and multidisciplinary evaluation can help clinicians decide on the best course of treatment for individual patients. Cystectomy, perioperative chemotherapy, and curative-intent bladder preservation are reasonable options in healthy older adults. Observation should be limited to patients with extremely poor performance status and very limited life expectancy.
AB - Purpose: Despite the fact that bladder cancer patients have the highest median age of any type of cancer, older patients with muscle invasion are often under-treated. Methods: In this review, we report the most up to date literature on the patterns of care and treatment of older patients with muscle invasive bladder cancer. Data on under-treatment, geriatric principles, cystectomy, perioperative chemotherapy, and bladder preservation for older patients are presented and analyzed. Conclusion: Chronologic age should not exclude patients from curative-intent therapy. Functional age as determined by geriatric assessments and multidisciplinary evaluation can help clinicians decide on the best course of treatment for individual patients. Cystectomy, perioperative chemotherapy, and curative-intent bladder preservation are reasonable options in healthy older adults. Observation should be limited to patients with extremely poor performance status and very limited life expectancy.
KW - Antineoplastic agents
KW - Cystectomy
KW - Geriatric assessment
KW - Radiotherapy
KW - Urinary bladder neoplasms
UR - http://www.scopus.com/inward/record.url?scp=84954393007&partnerID=8YFLogxK
U2 - 10.1007/s00345-015-1708-z
DO - 10.1007/s00345-015-1708-z
M3 - Article
C2 - 26497825
AN - SCOPUS:84954393007
SN - 0724-4983
VL - 34
SP - 3
EP - 11
JO - World Journal of Urology
JF - World Journal of Urology
IS - 1
ER -