TORONTO, Sept. 28 -- For high-risk bladder cancer, a decision on aggressive versus conservative therapy depends on age and quality-of-life preferences, according to investigators here.
Their findings suggest that patients with stage T1G3 bladder cancer, ages 60 and younger, live longer and have better quality of life with immediate surgery, whereas a conservative approach seems to offer the most benefits for older patients, Shabbir M. H. Alibhai, M.D., of the University of Toronto, and colleagues, concluded online in Public Library of Science - Medicine.
"The decision to pursue immediate cystectomy versus conservative therapy should be based on discussions that consider patient age, comorbid status, and an individual's preference for particular postcystectomy health states," the authors wrote. "Patients over the age of 70 years or those who place high value on sexual function, gastrointestinal function, or bladder preservation may benefit from a more conservative initial therapeutic approach."
Treatment of T1G3 bladder cancer remains controversial. Improved survival with immediate cystectomy may be offset by potential detrimental effects on quality of life and by competing mortality risks in older patients and those with significant comorbidities.
