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TOPLINE:

When older and younger patients have similar baseline health, those aged 80 years or older do not face higher risks for short-term death, major complications, or hospital readmissions after radical cystectomy.

METHODOLOGY:

• Researchers analyzed data from a high-volume center in Germany to compare short-term outcomes after open radical cystectomy in older adults and younger peers.
• They included 879 adults (median age, 69 years; 76.8% male) who underwent surgery between 2015 and 2024. Of them, 114 were aged 80-89 years.
• After propensity score matching for multiple measures such as comorbidities and renal function, the analysis included 97 octogenarians and 97 younger patients.
• The primary endpoints were mortality at 30 and 90 days. Secondary endpoints included complications during the hospital stay and readmission rates at 30 and 90 days.

TAKEAWAY:

• In the full cohort, octogenarians had higher rates of mortality than younger patients at 30 days (6.1% vs 1.4%; P = .003) and 90 days (10.5% vs 3.9%; P = .004).
• Following matching, no statistically significant difference was observed in either 30-day mortality (6.2% vs 2.1%; P = .28) or 90-day mortality (10.3% vs 4.1%; P = .17) between the groups.
• Being 80 years or older was not an independent predictor of 90-day mortality, major complications, or readmissions.
• A score indicating substantive functional limitations with one or more moderate-to-severe diseases such as chronic obstructive pulmonary disease was associated with major complications and 90-day mortality in both the unmatched and matched cohorts (P < .05 for all).

IN PRACTICE:

“These findings indicate that chronological age alone provides limited prognostic information when considered in isolation, whereas physiological reserve and comorbidity burden appear to be the primary determinants of postoperative risk,” the researchers of the study wrote.

SOURCE:

The study was led by Maurin Helen Mangold, Medical Faculty Mannheim, Heidelberg University, Heidelberg, Germany. It was published online on June 3 in the World Journal of Urology.

LIMITATIONS:

The study was retrospective and conducted at a single center. The fewer number of events after matching limited statistical power. Researchers lacked data on frailty and functional status.

DISCLOSURES:

The study did not receive any specific funding. The authors declared having no competing interests.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.