Evidence map›Paper›PMID 40205754›Full record

SynthesisBJU international2025

Radical cystectomy mortality in older patients: a systematic review and meta-analysis.

Jake Tempo, Sulleyman Felemban, Kirby R Qin, Marlon Perera, Joseph Ischia, Damien Bolton, Declan G Murphy, Brian Kelly, David I Watson, Michael O'Callaghan

Abstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in BJU international, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed.

  1. Article
  2. Article
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  4. Article
  5. Article
  6. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Jake TempoCollege of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia.ORCID https://orcid.org/0000-0002-7404-2356
Sulleyman FelembanDepartment of Surgery, Austin Health, Melbourne, Victoria, Australia.
Kirby R QinDepartment of Surgery, Austin Health, Melbourne, Victoria, Australia.ORCID https://orcid.org/0000-0001-5215-5985
Marlon PereraDepartment of Surgery, Austin Health, Melbourne, Victoria, Australia.ORCID https://orcid.org/0000-0002-1138-6389
Joseph IschiaDepartment of Surgery, Austin Health, Melbourne, Victoria, Australia.
Damien BoltonDepartment of Surgery, Austin Health, Melbourne, Victoria, Australia.
Declan G MurphyPeter MacCallum Cancer Centre, Melbourne, Victoria, Australia.ORCID https://orcid.org/0000-0002-7500-5899
Brian KellyPeter MacCallum Cancer Centre, Melbourne, Victoria, Australia.ORCID https://orcid.org/0000-0001-9554-3953
David I WatsonCollege of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia.
Michael O'CallaghanCollege of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia.ORCID https://orcid.org/0000-0001-5038-5859

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo perform a systematic review and meta-analysis of post-radical cystectomy (RC) mortality and complications in older people to aid decision-making pertinent to RC, as bladder cancer is typically a disease of older people, yet older people are less likely than their younger peers to undergo RC, predominantly due to concerns about morbidity and mortality of surgery. MATERIALS AND

methodsA systematic search of MEDLINE, Scopus and Ovid Emcare was performed in May 2023 for all studies in the past 20 years that reported mortality and/or complications in the 90-days following RC. All studies reporting mortality or complication outcomes in patient groups aged >75 years were included. Exclusion criteria included partial, or organ-sparing cystectomy, non-English language articles, and <20 patients aged >75 years.

resultsA total of 76 studies were included, with data from 58 504 older patients across five continents and 19 countries. Post-RC 90-day mortality was 11% in studies reporting outcomes for patients aged ≥80 years, and 7% in studies of patients aged ≥75 years. The 90-day mortality was higher in patients aged ≥80 years compared to patients aged <80 years (odds ratio [OR] 3.42, 95% confidence interval [CI] 1.62-7.22). Older people were more likely to experience a minor (Clavien-Dindo Grade I-II) postoperative complication than younger patients (OR 1.17, 95% CI 1.01-1.36), whereas there was no difference for major complications (Clavien-Dindo Garde III-IV; OR 1.00, 95% CI 0.63-1.60). A higher co-morbid status was more strongly correlated with 90-day mortality in older patients than in younger patients.

conclusionsOlder patients face higher postoperative mortality following RC than younger patients. Postoperative outcomes should be weighed against the high risk of cancer-specific death if no curative treatment is offered. Older people must be monitored closely postoperatively to try and prevent death as a result of escalation from minor and major complications.

Indexed as

CystectomyPostoperative ComplicationsUrinary Bladder NeoplasmsAgedAged, 80 and overAge FactorsHumansbladder cancercystectomymorbiditymortalitysystematic review

Identifiers

PMID40205754
PMCPMC12134441

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.