Urothelial cancer of the bladder (UCB) is usually a disease of the elderly. The influence of age on oncological outcomes remains controversial. This study aims to investigate the impact of age on UCB outcomes in Europe focusing particularly on young and very young patients. We collected data of 669 UCB patients treated with RC at our tertiary care center. We used various categorical stratifications as well as continuous age to investigate the association of age and tumor biology as well as endpoints with descriptive statistics and Cox regression. The median age was 67 years and the mean follow-up was 52 months. Eight patients (1.2%) were ≤40 years old and 39 patients (5.8%) were aged 41-50 years, respectively. In multivariable analysis, higher continuous age and age above the median were independent predictors for disease recurrence, and cancer-specific and overall mortality (all p-values ≤ 0.018). In addition, patients with age in the oldest tertile group had inferior cancer-specific and overall survival rates compared to their younger counterparts. Young (40-50 years) and very young (≤40 years) patients had reduced hazards for all endpoints, which, however, were not statistically significant. Age remains an independent determinant for survival after RC. Young adults did, however, not have superior outcomes in our analyses. Quality of life and complications are endpoints that need further evaluation in patients undergoing RC.
Journal of clinical medicine. 2019 Sep 13*** epublish ***
Florian Janisch, Hang Yu, Malte W Vetterlein, Roland Dahlem, Oliver Engel, Margit Fisch, Shahrokh F Shariat, Armin Soave, Michael Rink
Department of Urology, Medical University of Hamburg, Martinistraße 52, 20246 Hamburg, Germany. ., Department of Urology, Medical University of Hamburg, Martinistraße 52, 20246 Hamburg, Germany. ., Department of Urology, Medical University of Hamburg, Martinistraße 52, 20246 Hamburg, Germany. ., Department of Urology, Medical University of Hamburg, Martinistraße 52, 20246 Hamburg, Germany. ., Department of Urology, Medical University of Hamburg, Martinistraße 52, 20246 Hamburg, Germany. ., Department of Urology, Medical University of Hamburg, Martinistraße 52, 20246 Hamburg, Germany. ., Department of Urology, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria. ., Department of Urology, Medical University of Hamburg, Martinistraße 52, 20246 Hamburg, Germany. ., Department of Urology, Medical University of Hamburg, Martinistraße 52, 20246 Hamburg, Germany. .