Oncotarget

Research Papers:

Laparoscopic versus open radical cystectomy for patients with bladder cancer over 75-year-old: a prospective randomized controlled trial

Chen Yong _, Chen Daihui and Zhou Bo

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Oncotarget. 2017; 8:26565-26572. https://doi.org/10.18632/oncotarget.15717

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Abstract

Chen Yong1, Chen Daihui1, Zhou Bo2

1Department of Urology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China

2Department of Urology, Department of Urology, Daping Hospital, Third Military Medical University, Chongqing, China

Correspondence to:

Chen Yong, email: chenyongchongqing@163.com

Keywords: laparoscopic, open radical cystectomy, elderly patients, bladder cancer

Received: November 09, 2016     Accepted: February 10, 2017     Published: February 24, 2017

ABSTRACT

The aim of this study was to compare the morbidity, mortality, oncological results and quality of life between laparoscopic radical cystectomy (LRC) and open radical cystectomy (ORC) in the elderly patients over 75 years old. Between January 2012 and January 2015, 60 patients were recruited into this study, who were randomly assigned in a 1:1 ratio to either LRC or ORC group. Baseline patient characteristics, pathological factors, operative and postoperative characteristics, postoperative complications and survival data were retrospectively collected, analyzed and compared between the two groups. Patients in LRC group and ORC group had comparable baseline characteristics and pathological factors (all P > 0.05). LRC group required longer operative time (408.2 ± 76.9 vs. 311.7 ± 65.3 min, P = 0.000) and had less EBL (621.6 ± 100.7 vs. 1088.5 ± 109.4 ml, P = 0.000) compared with ORC group. The incidence of infection and ileus within 90 days after surgery in ORC group was significantly higher than LRC group(6.9% vs. 28.6%, P = 0.041; 3.4% vs. 25%, P = 0.025). At a median follow-up of 28 months (range 12–48 months), the survival analysis showed that there were no significant differences between the LRC and ORC groups in overall survival (log-rank χ2 = 0.122; P = 0.726), or progress-free survival (log-rank χ2 = 0.153; P = 0.696). In conclusion, this study confirmed that LRC could achieve similar tumor treatment efficacy compared to ORC, with fewer perioperative complications and less blood loss. We suggest that LRC should be considered as the primary intervention for patients aged over 75 years old with muscle invasive bladder cancer or non-muscle invasive bladder cancer with high risk factors.


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