| 論文種別 | 原著(症例報告除く) |
| 言語種別 | 英語 |
| 査読の有無 | その他(不明) |
| 表題 | Age-stratified outcomes of radical cystectomy for muscle-invasive bladder cancer: a nationwide multicenter study of 1867 patients in Japan. |
| 掲載誌名 | 正式名：Japanese journal of clinical oncology 略 称：Jpn J Clin Oncol ISSNコード：14653621/03682811 |
| 掲載区分 | 国外 |
| 巻・号・頁 | pp.Online ahead of print |
| 著者・共著者 | Taketo Kawai, Jun Miki, Rikiya Taoka, Ryoichi Saito, Wataru Fukuokaya, Yoshiyuki Matsui, Yoichi Fujii, Shingo Hatakeyama, Takashi Kawahara, Ayumu Matsuda, Minoru Kato, Tomokazu Sazuka, Takeshi Sano, Fumihiko Urabe, Soki Kashima, Hirohito Naito, Yoji Murakami, Makito Miyake, Kei Daizumoto, Yuto Matsushita, Masashi Nakayama, Takashi Matsumoto, Yusuke Sugino, Kenichiro Shiga, Noriya Yamaguchi, Shingo Yamamoto, Keiji Yasue, Takashige Abe, Shotaro Nakanishi, Katsuyoshi Hashine, Masato Fujii, Kiyoaki Nishihara, Keita Kobayashi, Shuichi Tatarano, Koichiro Wada, Sho Sekito, Ryo Maruyama, Naotaka Nishiyama, Hiroyuki Nishiyama, Hiroshi Kitamura, Haruki Kume, |
| 発行年月 | 2026/01 |
| 概要 | BACKGROUND:Radical cystectomy (RC) remains the standard treatment for muscle-invasive bladder cancer (MIBC), but is highly invasive and may cause functional decline, especially among geriatric patients. This study evaluated age-stratified outcomes of RC through a nationwide, multi-institutional cohort in Japan.METHODS:We analyzed 1867 patients with MIBC who underwent RC at 36 institutions, stratified into five age groups: <60, 60-69, 70-74, 75-79, and ≥80 years. The baseline characteristics, perioperative factors, and oncological outcomes were compared.RESULTS:Patients aged ≥80 years had significantly worse overall survival (OS, P < .001), cancer-specific survival (CSS, P = .006), and disease-free survival (DFS, P = .004) after RC. Although preoperative clinical T stage was comparable (P = .22), patients aged ≥80 years less frequently received neoadjuvant chemotherapy (NAC), and more often showed pathological extravesical extension and positive surgical margins (all P < .001). The incidence of grade ≥3 complications and 30-day mortality were comparable, whereas 90-day mortality was higher in this group (P = .047). Multivariable Cox analysis confirmed age ≥80 years as an independent predictor for unfavorable OS (P < .001), CSS (P = .017), and DFS (P = .018). Among patients aged ≥80 years, the use of NAC was associated with better OS (P = .033), particularly in those with Eastern Cooperative Oncology Group performance status of 0 (P = .015).CONCLUSION:Patients aged ≥80 years had significantly worse oncological outcomes after RC. NAC may improve OS in selected older patients with good performance status. |
| DOI | 10.1093/jjco/hyaf218 |
| PMID | 41543041 |