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題名 | Does Radical Cystectomy Outperform Other Bladder Preservative Treatments in Elderly Patients with Advanced Bladder Cancer?= |
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作者 | Chen, Chin-li; Liu, Chin-yu; Cha, Tai-lung; Hsu, Chien-yeh; Chou, Yu-ching; Wu, Sheng-tang; Meng, En; Sun, Guang-huan; Yu, Dah-shyong; Tsao, Chih-wei; |
期刊 | Journal of the Chinese Medical Association |
出版日期 | 20150800 |
卷期 | 78:8 2015.08[民104.08] |
頁次 | 頁469-474 |
分類號 | 416.274 |
語文 | eng |
關鍵詞 | Advanced bladder tumor; Chemoradiotherapy; Old age; Radical cystectomy; Transurethral resection of bladder tumor; |
英文摘要 | BACKGROUND: To assess the impacts of age, performance status, and clinical stage on advanced urothelial carcinoma of the bladder (UCB) in patients treated with different treatment modalities. METHODS: This retrospective study included 160 patients who underwent radical cystectomy (RC) with/without neoadjuvant or adjuvant chemoradiotherapy, palliative chemotherapy/radiotherapy/chemoradiotherapy (CRT), and transurethral resection of bladder tumor (TURBT) monotherapy for advanced UCB in one institution from 2000 to 2010. Kaplan-Meier analysis was used to calculate the survival distributions of overall survival (OS). The quality of life of the patients was also analyzed. RESULTS: The median age of the patients was 74.0 years, and the mean survival interval was 31.5 months. The 2-year OS was significantly different among the three modalities [RC > TURBT monotherapy, odds ratio (OR): 1.86, 95% CI: 1.17-2.96, p = 0.009; CRT > TURBT monotherapy, OR: 1.65, 95% CI: 1.06-2.57, p = 0.026]. There were no significant differences in the 5- and 10-year OS rates between the three treatment modalities. Those younger than 76 years receiving RC had a significantly better 2-year OS than those undergoing CRT and TURBT monotherapy (RC > TURBT monotherapy, OR: 2.38; 95% CI: 1.30-4.33, p = 0.005). The number and duration of re-hospitalizations were highest in the CRT group and lowest in the TURBT group. CONCLUSION: The short- and long-term OS rates of the three modalities were similar in those older than 76 years. Therefore, patients younger than age 76 years are likely to have a better outcome undergoing radical cystectomy for advanced UCB. |
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