Benjamin w et al. – This registry–based analysis (2004–2013) investigated treatment patterns and survival outcomes in 9270 elderly patients (age ≥80 years) with muscle–invasive bladder cancer. The authors concluded that chemoradiation (CRT) is an alternative definitive treatment strategy with survival, which is similar to radical cystectomy (RC) and superior to either chemotherapy (CT) or radiation therapy (RT) alone. Additional survival could be possible if the patient receives neoadjuvant or adjuvant chemotherapy with surgery.

Methods

• Elderly patients with muscle–invasive (cT2–T4aN0M0) bladder cancer underwent RC, RC plus chemotherapy (RC+C), RT, CT, CRT, or no treatment. Kaplan–Meier, log–rank, multivariate Cox proportional hazards regression, and propensity score matching were performed.

Results

• The median overall survival (OS) for patients treated with RC alone was 23.2 months, which is significantly superior to CT or RT alone.
• The median OS for CRT was 27.3 months and statistically close to RC alone.
• The longest median OS of 34.5 months was observed in patients treated with RC+C, which is significantly greater than both CRT and RC alone.
• Multivariate analysis and propensity score matching depicted a better OS in patients treated with RC+C.