Frailty a Factor in Urinary Diversion Choice for Patients With Bladder Cancer

Frailty has a role in the type of urinary diversion selected after radical cystectomy in patients with muscle-invasive bladder cancer, according to a study published online in the International Journal of Urology. 

Researchers used the Fried phenotype criteria, the modified frailty index, and the frailty discriminant score to prospectively evaluate frailty in 88 patients undergoing radical cystectomy and urinary diversion for localized muscle-invasive bladder cancer. The type of urinary diversion patients received were selected by the operating surgeon based on performance status, comorbidities, tumor status, and patient preference. 

Among participants, whose median age was 68, 61% received an orthotopic neobladder and 52% experienced postoperative complications, according to the study. Fried phenotype criteria and frailty discriminant score were significantly linked with selection of nonorthotopic neobladder urinary diversion.  

Postoperative complications in participants, meanwhile, were significantly associated with modified frailty index. A higher frailty discriminant score was significantly associated with poor overall survival, researchers found, although Fried phenotype criteria and modified frailty index were not. 

“Frailty is significantly associated with the type of urinary diversion,” they concluded, “and it should be considered for the selection of urinary diversion in muscle-invasive bladder cancer patients undergoing radical cystectomy.”

—Jolynn Tumolo

Reference:

Okita K, Hatakeyama S, Momota M, et al. Frailty is significantly associated with the type of urinary diversion in patients with muscle-invasive bladder cancer [published online ahead of print, 2020 May 25]. Int J Urol. 2020;10.1111/iju.14263. doi:10.1111/iju.14263