Radical cystectomy in patients aged < 80 years versus ≥ 80 years: analysis of preoperative geriatric assessment scores in predicting postoperative morbidity and mortality - Summary - MDSpire

Radical cystectomy in patients aged < 80 years versus ≥ 80 years: analysis of preoperative geriatric assessment scores in predicting postoperative morbidity and mortality

  • By

  • Gregor Duwe

  • Isabel Wagner

  • Katarzyna E. Banasiewicz

  • Lisa Johanna Frey

  • Nikita Dhruva Fischer

  • Johann Bierlein

  • Niklas Rölz

  • Maximilian Haack

  • Rene Mager

  • Christopher C. M. Neumann

  • Katharina Boehm

  • Peter Sparwasser

  • Igor Tsaur

  • Mohamed M. Kamal

  • Axel Haferkamp

  • Maximilian Peter Brandt

  • Thomas Höfner

  • September 30, 2024

  • 0 min

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Objective:

To compare geriatric assessment scores (GAS) in predicting severe postoperative complications and mortality in patients undergoing radical cystectomy (RC), particularly focusing on those aged 80 years and older, and to identify the most predictive GAS.

Key Findings:
  • Patients aged ≥ 80 years had a higher incidence of severe complications (CDC grade ≥ IIIb) at 41.1% compared to 27.7% in those < 80 years (p-value < 0.05).
  • 30-day postoperative mortality was significantly higher in patients ≥ 80 years (16.4% vs. 1.7%, p-value < 0.05).
  • Positive resection margins were more frequent in patients ≥ 80 years (20.69% vs. 9.48%, p-value < 0.05).
  • Higher ASA classification (≥ 3) was noted in 72.3% of patients ≥ 80 years compared to 58% in younger patients (p-value < 0.05).
Interpretation:

Geriatric assessment scores, particularly POSPOM and ASA classification, are crucial in predicting postoperative outcomes in elderly patients undergoing radical cystectomy, indicating a need for tailored preoperative evaluations to improve patient outcomes.

Limitations:
  • The study is retrospective and conducted at a single institution, which may limit generalizability to broader populations.
  • The sample size for patients aged ≥ 80 years was relatively small, potentially affecting the robustness of the findings.
Conclusion:

Geriatric assessment scores can effectively predict postoperative morbidity and mortality in elderly patients undergoing radical cystectomy, emphasizing the importance of comprehensive preoperative evaluations in this demographic.

Original Source(s)

Radical cystectomy in patients aged < 80 years versus ≥ 80 years: analysis of preoperative geriatric assessment scores in predicting postoperative morbidity and mortality

  • by Gregor Duwe, Isabel Wagner, Katarzyna E. Banasiewicz, Lisa Johanna Frey, Nikita Dhruva Fischer, Johann Bierlein, Niklas Rölz, Maximilian Haack, Rene Mager, Christopher C. M. Neumann, Katharina Boehm, Peter Sparwasser, Igor Tsaur, Mohamed M. Kamal, Axel Haferkamp, Maximilian Peter Brandt, Thomas Höfner

  • September 30, 2024

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