TY - JOUR AU - Calò, B. AU - Carvalho-Dias, E. AU - Autorino, R. PY - 2018/12/15 Y2 - 2024/03/28 TI - Radical cystectomy and orthotopic neobladder in fit octogenarians JF - JOURNAL OF GERONTOLOGY AND GERIATRICS JA - Gerontology and Geriatrics VL - 66 IS - 4 SE - Clinical Observations in Geriatrics - Clinical Experiences and Case Reports DO - UR - https://www.jgerontology-geriatrics.com/article/view/82 SP - 265-268 AB - Background and aims. Octogenarians are usually considered poor candidates to orthotopic neobladder afterradical cystectomy. Herein we report our experience with feasibility, efficacy and safety of orthotopic neobladderin octogenarians.Patients and methods. Two 83 year-old patients with muscle invasive urothelial carcinoma were consideredeligible for orthotopic neobladder after radical cystectomy. Their cognitive status was excellent; no serious comorbidities.Follow-up consisted of chest/abdomen computed tomography every six months for three years,then yearly. Urinary continence was assessed recording day-time and night-time used-pad and InternationalConsultation on Incontinence Questionnaire (ICIQ).Results. Final pathology was high-grade urothelial carcinoma (pT2N0) in patient A and high-grade urothelialcarcinoma with neuroendocrine component (pT3N1) plus prostate adenocarcinoma Gleason 3+3 (pT2a) in patientB. No complication occurred. However, patient B progressed (bone metastases) after 3 months and died7 months after surgery due to the aggressive behaviour of the neuroendocrine tumor. Patient B presented 74months after surgery with a 3.5 tumor of the left renal pelvis. He refused further surgical treatment and died 13months later due to metastatic disease. Patient A scored 12 at 3 month ICIQ as he needed 1 pad day-time and1 night-time but experienced progressive improvement up to full day-time continence and safety liner nighttime,scoring 2 at 1-year ICIQ. Early functional outcome was good in patient B who was continent day-time butused 1 pad night-time. His ICIQ score was 6.Conclusions. Age is not an absolute contraindication to neobladder construction providing adequate cognitivestatus and absence of major comorbidities. ER -