The effect of age on bladder cancer incidence, prognosis and therapy Journal Article
| Authors: | Shariat, S. F.; Lee, R.; Lowrance, W. T.; Bochner, B. H. |
| Article Title: | The effect of age on bladder cancer incidence, prognosis and therapy |
| Abstract: | Age is now widely accepted as the single greatest risk factor for developing urothelial carcinoma of the bladder (UCB). The aim of this article is to assess the incidence, prognosis and therapy of UCB in the elderly. Using MEDLINE, we performed a search of the literature between January 1966 and July 2009. The link between aging and cancer is more complex than the simple passage of time; certain genes may be activated while others may be suppressed with advancing age. Treatments for nonmuscle-invasive UCB are generally well-tolerated by the elderly. However, several studies have demonstrated a lower response rate to intravesical immunotherapy in the elderly. While elderly patients have a higher rate of perioperative complication and mortality after radical cystectomy, the difference is too small and insufficient to avoid radical cystectomy in these patients. Similarly, in certain selected cases, centers of excellence report similar complication rates in elderly patients, regardless of the type of urinary diversion. The optimal application of perioperative chemotherapy is dependent on the degree of compromise of the organ systems through comorbid conditions and physiologic deterioration. Restrictive case selection and proactive postoperative rehabilitation are important for elderly patients to obtain good results. Age alone does not preclude optimal treatment for patients with aggressive UCB. Radical surgery, urinary diversion and systemic chemotherapy are feasible, safe and efficacious in the treatment of adequately selected elderly UCB patients. It is imperative that healthcare practitioners and researchers from disparate disciplines collectively focus their efforts to appropriately meet the multifaceted medical and psychosocial needs of the elderly. © 2010 Future Medicine Ltd. |
| Keywords: | survival; clinical trial; drug tolerability; neutropenia; review; cisplatin; interferon; systemic therapy; unspecified side effect; gemcitabine; postoperative care; chemotherapy; neurotoxicity; antineoplastic agent; cancer incidence; bcg vaccine; carboplatin; cancer immunotherapy; quality of life; nephrotoxicity; recurrence; bladder cancer; age; gastrointestinal toxicity; immunotherapy; cardiovascular disease; cerebrovascular disease; drug response; cystectomy; urinary diversion; patient safety; urothelial carcinoma; surgical mortality; aging; therapy effect; perioperative period; elderly; thrombotic thrombocytopenic purpura; rehabilitation care; raynaud phenomenon; drug elimination; ototoxicity; pyelonephritis |
| Journal Title: | Aging Health |
| Volume: | 6 |
| Issue: | 5 |
| ISSN: | 1745-509X |
| Publisher: | Future Medicine |
| Date Published: | 2010-10-01 |
| Start Page: | 649 |
| End Page: | 659 |
| Language: | English |
| DOI: | 10.2217/ahe.10.61 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | --- - "Export Date: 20 April 2011" - "Source: Scopus" |
Altmetric
Citation Impact
BMJ Impact Analytics
Related MSK Work