PMID- 33976912
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220422
IS  - 2080-4806 (Print)
IS  - 2080-4873 (Electronic)
IS  - 2080-4806 (Linking)
VI  - 74
IP  - 1
DP  - 2021
TI  - Evaluation of comorbidity indices in determining the most suitable candidates for 
      uro-oncological surgeries in elderly men.
PG  - 24-38
LID - 10.5173/ceju.2021.0246 [doi]
AB  - INTRODUCTION: We aimed to evaluate the superiority of different comorbidity 
      indices in determining the most suitable elderly male candidates for 
      uro-oncological operations. While making this assessment, we also aimed to 
      determine the risk factors that may affect surgery-related major complications 
      and overall survival. MATERIAL AND METHODS: Data of 543 male patients, 60 years 
      or older, who underwent uro-oncological surgery (radical cystectomy, radical 
      prostatectomy, radical or partial nephrectomy, transurethral resection of bladder 
      tumor) between September 2009 and January 2019 were retrospectively evaluated. 
      Demographic, clinical and pathological characteristics of the patients, 
      preoperative comorbidity indices, postoperative complications, length of 
      hospitalization, re-admission rates within 90 days and postoperative follow-up 
      outcomes were recorded. Patients in similar tumor stages were divided into 
      different subgroups. All subgroups were divided into two main categories: middle 
      age (60-69 years-old) and elderly age (>/=70-years-old). RESULTS: No significant 
      difference was found for all types of surgery in terms of postoperative outcomes 
      in both age groups (p >0.05). Age-adjusted Charlson Comorbidity Index (ACCI), 
      Preoperative Score to Predict Postoperative Mortality (POSPOM), Rockwood Frailty 
      Index (RFI) and tumor characteristics were found to be more significant 
      predictors for postoperative major complications and overall mortality than 
      Eastern Cooperative Oncology Group (ECOG), American Society of Anesthesiologists 
      (ASA) and New York Heart Association (NYHA) functional classification. 
      CONCLUSIONS: Our findings show that patient age alone is not a risk factor for 
      increased postoperative complications and overall mortality. Although many 
      different comorbidity indices have been used in urological practice, ACCI, POSPOM 
      and RFI are more valuable predictors. Uro-oncological surgeries may be performed 
      safely in elderly males after a good clinical decision based on these indices.
CI  - Copyright by Polish Urological Association.
FAU - Selvi, Ismail
AU  - Selvi I
AD  - Basaksehir Cam ve Sakura City Hospital, Department of Urology, Istanbul, Turkey.
FAU - Arik, Ali Ihsan
AU  - Arik AI
AD  - Health Science University, Dr. Abdurrahman Yurtaslan Ankara Oncology Training and 
      Research Hospital, Department of Urology, Ankara, Turkey.
FAU - Baydilli, Numan
AU  - Baydilli N
AD  - Erciyes University Medical School, Department of Urology, Kayseri, Turkey.
FAU - Basay, Mehmet Sinan
AU  - Basay MS
AD  - Health Science University, Dr. Abdurrahman Yurtaslan Ankara Oncology Training and 
      Research Hospital, Department of Urology, Ankara, Turkey.
FAU - Basar, Halil
AU  - Basar H
AD  - Health Science University, Dr. Abdurrahman Yurtaslan Ankara Oncology Training and 
      Research Hospital, Department of Urology, Ankara, Turkey.
LA  - eng
PT  - Journal Article
DEP - 20210305
PL  - Poland
TA  - Cent European J Urol
JT  - Central European journal of urology
JID - 101587101
PMC - PMC8097655
OTO - NOTNLM
OT  - aging male
OT  - comorbidity indices
OT  - overall survival
OT  - postoperative complications
OT  - uro-oncological surgeries
COIS- The authors declare no conflicts of interest.
EDAT- 2021/05/13 06:00
MHDA- 2021/05/13 06:01
PMCR- 2021/01/01
CRDT- 2021/05/12 07:05
PHST- 2020/08/20 00:00 [received]
PHST- 2020/10/01 00:00 [revised]
PHST- 2021/02/10 00:00 [accepted]
PHST- 2021/05/12 07:05 [entrez]
PHST- 2021/05/13 06:00 [pubmed]
PHST- 2021/05/13 06:01 [medline]
PHST- 2021/01/01 00:00 [pmc-release]
AID - 0246 [pii]
AID - 10.5173/ceju.2021.0246 [doi]
PST - ppublish
SO  - Cent European J Urol. 2021;74(1):24-38. doi: 10.5173/ceju.2021.0246. Epub 2021 
      Mar 5.