Abstract：
UNASSIGNED: There is interest in using bladder-preserving therapy as an alternative definitive therapy for muscle invasive bladder cancer in certain high-risk groups such as the elderly.
UNASSIGNED: To determine if bladder-preserving therapy represents a safer alternative to surgical intervention in elderly patients with muscle invasive bladder cancer.
UNASSIGNED: We surveyed the Surveillance, Epidemiology and End Results database (SEER) for cases of non-metastasized malignant bladder cancer in patients aged 80+. Survival outcomes with radical cystectomy (RC) with or without chemotherapy were compared to those after chemotherapy and radiation without cystectomy. We performed log-rank tests and Kaplan-Meier and cox regression and hazard analyses before and after propensity score matching.
UNASSIGNED: A total of 2995 patients were identified, with 49.98% treated with RC only, 8.65% treated with RC/chemotherapy, and 41.37% treated with chemotherapy and radiation without RC. Median overall survival for the RC only, RC/chemotherapy and chemotherapy/radiation groups were 31.4, 44.1, and 24.6 months, respectively. On multivariate analysis, hazard ratios (reference: RC/chemotherapy group) were RC Only (HR = 1.408 (95% CI 1.188-1.669), p < 0.0001) and chemotherapy/radiation (HR = 1.650 (95% CI 1.390-1.959), p < 0.0001). After matching the chemotherapy/radiation and RC/chemotherapy groups, the former continued to show survival hazard (HR = 1.744 (95% CI 1.414-2.155), p < 0.0001).
UNASSIGNED: Octogenarians should be offered definitive local therapy for their localized bladder cancer including RC and chemotherapy. Bladder-sparing alternatives should be reserved for patients unfit for surgery.
UNASSIGNED: To determine if bladder-preserving therapy represents a safer alternative to surgical intervention in elderly patients with muscle invasive bladder cancer.
UNASSIGNED: We surveyed the Surveillance, Epidemiology and End Results database (SEER) for cases of non-metastasized malignant bladder cancer in patients aged 80+. Survival outcomes with radical cystectomy (RC) with or without chemotherapy were compared to those after chemotherapy and radiation without cystectomy. We performed log-rank tests and Kaplan-Meier and cox regression and hazard analyses before and after propensity score matching.
UNASSIGNED: A total of 2995 patients were identified, with 49.98% treated with RC only, 8.65% treated with RC/chemotherapy, and 41.37% treated with chemotherapy and radiation without RC. Median overall survival for the RC only, RC/chemotherapy and chemotherapy/radiation groups were 31.4, 44.1, and 24.6 months, respectively. On multivariate analysis, hazard ratios (reference: RC/chemotherapy group) were RC Only (HR = 1.408 (95% CI 1.188-1.669), p < 0.0001) and chemotherapy/radiation (HR = 1.650 (95% CI 1.390-1.959), p < 0.0001). After matching the chemotherapy/radiation and RC/chemotherapy groups, the former continued to show survival hazard (HR = 1.744 (95% CI 1.414-2.155), p < 0.0001).
UNASSIGNED: Octogenarians should be offered definitive local therapy for their localized bladder cancer including RC and chemotherapy. Bladder-sparing alternatives should be reserved for patients unfit for surgery.
摘要：
■在某些高风险人群如老年人中，使用膀胱保留疗法作为肌肉浸润性膀胱癌的替代确定性疗法是有兴趣的。
■为了确定保留膀胱治疗是否代表老年肌层浸润性膀胱癌患者手术干预的更安全的替代方法。
■我们调查了监控，流行病学和最终结果数据库（SEER），用于80岁以上患者的非转移性恶性膀胱癌病例。将有或没有化疗的根治性膀胱切除术（RC）的生存结果与没有进行膀胱切除术的化疗和放疗后的生存结果进行比较。我们在倾向评分匹配前后进行了对数秩检验、Kaplan-Meier和cox回归和风险分析。
■共确定了2995名患者，49.98%只接受RC治疗，8.65%接受RC/化疗，41.37%接受化疗和放疗，无RC。仅RC的总体生存率中位数，RC/化疗和化疗/放疗组分别为31.4、44.1和24.6个月，分别。在多变量分析中，风险比（参考：RC/化疗组）仅RC（HR=1.408（95％CI1.188-1.669），p<0.0001)和化疗/放疗(HR=1.650(95%CI1.390-1.959)，p<0.0001)。化疗/放疗组和RC/化疗组匹配后，前者继续表现出生存危险(HR=1.744(95%CI1.414-2.155)，p<0.0001)。
■对于局部膀胱癌，应提供明确的局部治疗，包括RC和化疗。对于不适合手术的患者，应保留保留膀胱的替代品。
■为了确定保留膀胱治疗是否代表老年肌层浸润性膀胱癌患者手术干预的更安全的替代方法。
■我们调查了监控，流行病学和最终结果数据库（SEER），用于80岁以上患者的非转移性恶性膀胱癌病例。将有或没有化疗的根治性膀胱切除术（RC）的生存结果与没有进行膀胱切除术的化疗和放疗后的生存结果进行比较。我们在倾向评分匹配前后进行了对数秩检验、Kaplan-Meier和cox回归和风险分析。
■共确定了2995名患者，49.98%只接受RC治疗，8.65%接受RC/化疗，41.37%接受化疗和放疗，无RC。仅RC的总体生存率中位数，RC/化疗和化疗/放疗组分别为31.4、44.1和24.6个月，分别。在多变量分析中，风险比（参考：RC/化疗组）仅RC（HR=1.408（95％CI1.188-1.669），p<0.0001)和化疗/放疗(HR=1.650(95%CI1.390-1.959)，p<0.0001)。化疗/放疗组和RC/化疗组匹配后，前者继续表现出生存危险(HR=1.744(95%CI1.414-2.155)，p<0.0001)。
■对于局部膀胱癌，应提供明确的局部治疗，包括RC和化疗。对于不适合手术的患者，应保留保留膀胱的替代品。
