Use of Neoadjuvant Chemotherapy in Elderly Patients With Muscle- Invasive Bladder Cancer: A Population-Based Study, 2006-2017

Abstract

OBJECTIVES/INTRODUCTION: Neoadjuvant chemotherapy (NAC) prior to radical cystectomy (RC) for muscle-invasive bladder cancer (MIBC) is associated with survival benefit across patients of all ages, yet it is not offered to many elderly patients. We aimed to evaluate age-based disparity in treatment and outcomes of MIBC. METHODS: Using the National Cancer Database, we identified patients with MIBC from 2006 to 2017. Use of treatment modalities was compared between age groups. A second analysis compared perioperative outcomes and overall survival (OS) in elderly patients (70 years or older) undergoing RC with NAC vs no NAC. Propensity score weighting (PSW) was used for each analysis. RESULTS: In 70,911 patients, use of NAC with RC was lower in patients 70 years or older (7.2% vs 20.9%; P