26swdgu04 10.3205/26swdgu04 urn:nbn:de:0183-26swdgu040 Meeting Abstract Mangold Mangold Maurin Helen MH

Universitätsmedizin Mannheim, Klinik für Urologie und Urochirurgie, Mannheim, Deutschland

author Egen Egen L. L

Universitätsmedizin Mannheim, Klinik für Urologie und Urochirurgie, Mannheim, Deutschland

author Carl Carl N. N

Universitätsmedizin Mannheim, Klinik für Urologie und Urochirurgie, Mannheim, Deutschland

author Michel Michel M.S. MS

Universitätsmedizin Mannheim, Klinik für Urologie und Urochirurgie, Mannheim, Deutschland

author Westhoff Westhoff N. N

Universitätsmedizin Mannheim, Klinik für Urologie und Urochirurgie, Mannheim, Deutschland

author Kowalewski Kowalewski K.-F. K-F

Universitätsmedizin Mannheim, Klinik für Urologie und Urochirurgie, Mannheim, Deutschland

author German Medical Science GMS Publishing House

Düsseldorf

610 20260610 engl This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. Dieser Artikel ist ein Open-Access-Artikel und steht unter den Lizenzbedingungen der Creative Commons Attribution 4.0 License (Namensnennung). M0649 04 Südwestdeutsche Gesellschaft für Urologie e.V. 66. Jahrestagung der Südwestdeutschen Gesellschaft für Urologie e.V. Vortragssitzung 1: Urothelkarzinom Koblenz 20260610 20260613 V1.4 TextIntroduction: Patients aged ≥80 years undergo radical cystectomy (RC) significantly less frequently than younger patients, largely due to concerns about perioperative morbidity and mortality risk. We assessed whether chronological age independently predicts short-term mortality and morbidity after RC when comorbidity burden and physiological fitness are balanced.Method: We retrospectively analyzed 879 patients undergoing open RC (2015–2024) at a high-volume center. Octogenarians (80–89 years) were compared with patients <80 years. Propensity score matching (1:1 nearest neighbor; caliper 0.2 SD) balanced sex, ASA, Charlson Comorbidity Index, preoperative GFR, and BMI. Primary endpoints were 30- and 90-day mortality; secondary endpoints were major complications (Clavien–Dindo ≥IIIb) and 30-/90-day readmission. Multivariable logistic regression in the matched cohort assessed independent predictors.Results: Among 879 patients, 114 (13%) were octogenarians. In the unmatched cohort, octogenarians had higher 30-day (6.1% vs. 1.4%; p=0.003) and 90-day mortality (10.5% vs. 3.9%; p=0.004). After matching (n=202), mortality rates were no longer significantly different between groups (30-day: 5.9% vs. 1.0%, p=0.124; 90-day: 9.9% vs. 4.0%, p=0.166), despite remaining numerically higher in octogenarians. Major complications and readmissions were comparable between matched groups. In multivariable regression analysis, age ≥80 years was not an independent predictor of adverse outcomes, whereas ASA ≥3 independently predicted major complications.Conclusion: When comorbidity and physiological status are balanced, well-selected octogenarians can achieve short-term outcomes comparable to younger patients after RC. Chronological age alone should not preclude surgery; individualized risk assessment and treatment in experienced high-volume centers are essential. 0 0 0 0