LAUSR

Introduction We conducted this study to determine if, in appropriately selected elderly patients receiving neoadjuvant chemotherapy (NAC), clinical outcomes including pathologic complete response/downstaging and overall survival were similar to a younger cohort. Methods Chart review was performed on patients receiving NAC for urothelial carcinoma of the bladder (UCB) from 2004 to 2013. A total of 116 patients were identified that underwent NAC from 2004 to 2013 for ≥ cT2N0M0 UCB. Patients were excluded who received 2 cycles or less of chemotherapy (N = 18; 11 patients in the younger cohort, 7 in the elderly group; P = .74). Data was analyzed, and Kaplan‐Meir analysis curves were used for survival and recurrence. Results Forty‐six elderly patients (age ≥ 70 years) (67% cisplatin‐based regimen) were identified and compared with 70 (93% cisplatin‐based regimen) younger patients. The estimated glomerular filtration rate, performance status, preoperative hemoglobin, and body mass index were significantly worse in elderly patients. Dose reduction and pathologic downstaging to non–muscle‐invasive disease was not statistically different between older and younger patients Complete pathologic response in older patients (16%) and in the younger cohort (17%) were similar (P = .146). There was no significant difference in follow‐up, recurrence, or in median overall survival between patient groups (28 months elderly vs. 35 months younger; P = .78). Age was not an independent predictor of pathologic downstaging, complete response, overall survival, or recurrence‐free survival. Conclusions NAC in elderly patients (≥ 70 years old) demonstrated equivalent toxicity and oncologic outcomes in our single‐institution cohort. Although older patients had significantly poorer performance status and renal function, there were no differences in survival or response to NAC. Micro‐Abstract This study evaluated elderly patients with urothelial carcinoma of the bladder receiving neoadjuvant chemotherapy (NAC). Compared with a younger cohort of patients, NAC demonstrated equivalent toxicity and oncologic outcomes in our single‐institution cohort. Although older patients had significantly poorer performance status and renal function, there were no differences in survival or response to NAC.