{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T04:29:23Z","timestamp":1791779363881,"version":"4.3.4"},"reference-count":36,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2026,1,16]],"date-time":"2026-01-16T00:00:00Z","timestamp":1768521600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,4,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Radical cystectomy (RC) remains the standard treatment for muscle-invasive bladder cancer (MIBC), but is highly invasive and may cause functional decline, especially among geriatric patients. This study evaluated age-stratified outcomes of RC through a nationwide, multi-institutional cohort in Japan.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We analyzed 1867 patients with MIBC who underwent RC at 36 institutions, stratified into five age groups: &amp;lt;60, 60\u201369, 70\u201374, 75\u201379, and\u00a0\u226580\u00a0years. The baseline characteristics, perioperative factors, and oncological outcomes were compared.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Patients aged \u226580\u00a0years had significantly worse overall survival (OS, P\u00a0&amp;lt;\u00a0.001), cancer-specific survival (CSS, P\u00a0=\u00a0.006), and disease-free survival (DFS, P\u00a0=\u00a0.004) after RC. Although preoperative clinical T stage was comparable (P\u00a0=\u00a0.22), patients aged \u226580\u00a0years less frequently received neoadjuvant chemotherapy (NAC), and more often showed pathological extravesical extension and positive surgical margins (all P\u00a0&amp;lt;\u00a0.001). The incidence of grade\u00a0\u22653 complications and 30-day mortality were comparable, whereas 90-day mortality was higher in this group (P\u00a0=\u00a0.047). Multivariable Cox analysis confirmed age\u00a0\u226580\u00a0years as an independent predictor for unfavorable OS (P\u00a0&amp;lt;\u00a0.001), CSS (P\u00a0=\u00a0.017), and DFS (P\u00a0=\u00a0.018). Among patients aged \u226580\u00a0years, the use of NAC was associated with better OS (P\u00a0=\u00a0.033), particularly in those with Eastern Cooperative Oncology Group performance status of 0 (P\u00a0=\u00a0.015).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Patients aged \u226580\u00a0years had significantly worse oncological outcomes after RC. NAC may improve OS in selected older patients with good performance status.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/jjco\/hyaf218","type":"journal-article","created":{"date-parts":[[2025,12,30]],"date-time":"2025-12-30T12:37:19Z","timestamp":1767098239000},"page":"475-483","source":"Crossref","is-referenced-by-count":3,"title":["Age-stratified outcomes of radical cystectomy for muscle-invasive bladder cancer: a nationwide multicenter study of 1867 patients in Japan"],"prefix":"10.1093","volume":"56","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7279-2874","authenticated-orcid":false,"given":"Taketo","family":"Kawai","sequence":"first","affiliation":[{"name":"Department of Urology, International University of Health and Welfare Ichikawa Hospital , 6-1-14 Konodai, Ichikawa-shi, Chiba 272-0827 ,","place":["Japan"]},{"name":"Department of Urology, Graduate School of Medicine, The University of Tokyo , 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4638-8640","authenticated-orcid":false,"given":"Jun","family":"Miki","sequence":"additional","affiliation":[{"name":"Department of Urology, Jikei University Kashiwa Hospital , 163-1 Kashiwashita, Kashiwa-shi, Chiba 277-8567 ,","place":["Japan"]},{"name":"Department of Urology, The Jikei University School of Medicine , 3-25-8 Nishi-Shimbashi, Minato-ku, Tokyo 105-8461 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rikiya","family":"Taoka","sequence":"additional","affiliation":[{"name":"Department of Urology, Faculty of Medicine, Kagawa University , 1750-1 Ikenobe, Miki-cho, Kita-gun, Kagawa 761-0793 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryoichi","family":"Saito","sequence":"additional","affiliation":[{"name":"Department of Urology, Hyogo Medical University , 1-1 Mukogawacho, Nishinomiya-shi, Hyogo 663-8501 ,","place":["Japan"]},{"name":"Department of Urology, Kyoto University Graduate School of Medicine , 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto 606-8507 ,","place":["Japan"]},{"name":"Department of Urology and Andrology, Kansai Medical University , 2-3-1 Shinmachi, Hirakata-shi, Osaka 573-1191 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wataru","family":"Fukuokaya","sequence":"additional","affiliation":[{"name":"Department of Urology, Jikei University Kashiwa Hospital , 163-1 Kashiwashita, Kashiwa-shi, Chiba 277-8567 ,","place":["Japan"]},{"name":"Department of Urology, The Jikei University School of Medicine , 3-25-8 Nishi-Shimbashi, Minato-ku, Tokyo 105-8461 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshiyuki","family":"Matsui","sequence":"additional","affiliation":[{"name":"Department of Urology, National Cancer Center Hospital , 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoichi","family":"Fujii","sequence":"additional","affiliation":[{"name":"Department of Urology, Graduate School of Medicine, The University of Tokyo , 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0026-4079","authenticated-orcid":false,"given":"Shingo","family":"Hatakeyama","sequence":"additional","affiliation":[{"name":"Department of Urology, Hirosaki University Graduate School of Medicine , 5 Zaifumachi, Hirosaki-shi, Aomori 036-8562 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takashi","family":"Kawahara","sequence":"additional","affiliation":[{"name":"Department of Urology, Faculty of Medicine, University of Tsukuba , 2-1-1 Amakubo, Tsukuba-shi, Ibaraki 305-0005 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ayumu","family":"Matsuda","sequence":"additional","affiliation":[{"name":"Department of Urology, National Cancer Center Hospital , 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4171-6027","authenticated-orcid":false,"given":"Minoru","family":"Kato","sequence":"additional","affiliation":[{"name":"Department of Urology, Graduate School of Medicine, Osaka Metropolitan University , 1-5-7 Asahimachi, Abeno-ku, Osaka-shi, Osaka 545-0051 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8902-7853","authenticated-orcid":false,"given":"Tomokazu","family":"Sazuka","sequence":"additional","affiliation":[{"name":"Department of Urology, Graduate School of Medicine, Chiba University , 1-8-1 Inohana, Chuo-ku, Chiba-shi, Chiba 260-8670 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takeshi","family":"Sano","sequence":"additional","affiliation":[{"name":"Department of Urology, Kyoto University Graduate School of Medicine , 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto 606-8507 ,","place":["Japan"]},{"name":"Department of Urology and Andrology, Kansai Medical University , 2-3-1 Shinmachi, Hirakata-shi, Osaka 573-1191 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2599-8183","authenticated-orcid":false,"given":"Fumihiko","family":"Urabe","sequence":"additional","affiliation":[{"name":"Department of Urology, The Jikei University School of Medicine , 3-25-8 Nishi-Shimbashi, Minato-ku, Tokyo 105-8461 ,","place":["Japan"]},{"name":"Department of Urology, Jikei University Daisan Hospital , 4-11-1 Izumihoncho, Komae-shi, Tokyo 201-8601,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Soki","family":"Kashima","sequence":"additional","affiliation":[{"name":"Department of Urology, Akita University Graduate School of Medicine , 1-1-1 Hondo, Akita-shi, Akita 010-8543 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hirohito","family":"Naito","sequence":"additional","affiliation":[{"name":"Department of Urology, Faculty of Medicine, Kagawa University , 1750-1 Ikenobe, Miki-cho, Kita-gun, Kagawa 761-0793 ,","place":["Japan"]},{"name":"Department of Urology, Kurashiki Central Hospital , 1-1-1 Miwa, Kurashiki-shi, Okayama 710-8602 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-5176-0441","authenticated-orcid":false,"given":"Yoji","family":"Murakami","sequence":"additional","affiliation":[{"name":"Department of Urology, Graduate School of Life Science, Kumamoto University , 1-1-1 Honjo, Chuo-ku, Kumamoto-shi, Kumamoto 860-8556 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9503-7356","authenticated-orcid":false,"given":"Makito","family":"Miyake","sequence":"additional","affiliation":[{"name":"Department of Urology, Nara Medical University , 840 Shijo-cho, Kashihara-shi, Nara 634-8522 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kei","family":"Daizumoto","sequence":"additional","affiliation":[{"name":"Department of Urology, Tokushima University Graduate School of Biomedical Sciences , 3-18-1 Kuramoto-cho, Tokushima-shi, Tokushima 770-8503 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8159-9793","authenticated-orcid":false,"given":"Yuto","family":"Matsushita","sequence":"additional","affiliation":[{"name":"Department of Urology, Hamamatsu University School of Medicine , 1-20-1 Handayama, Higashi-ku, Hamamatsu-shi, Shizuoka 431-3192 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masashi","family":"Nakayama","sequence":"additional","affiliation":[{"name":"Department of Urology, Osaka International Cancer Institute , 3-1-69 Otemae, Chuo-ku, Osaka-shi, Osaka 540-8507 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1570-6340","authenticated-orcid":false,"given":"Takashi","family":"Matsumoto","sequence":"additional","affiliation":[{"name":"Department of Urology, Graduate School of Medical Sciences, Kyushu University , 3-1-1 Maidashi, Higashi-ku, Fukuoka-shi, Fukuoka 812-8582 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yusuke","family":"Sugino","sequence":"additional","affiliation":[{"name":"Department of Nephro-Urologic Surgery and Andrology, Mie University Graduate School of Medicine , 2-174 Edobashi, Tsu-shi, Mie 514-8507 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University School of Medicine , 3-25-8 Nishi-Shimbashi, Minato-ku, Tokyo 105-8461 ,","place":["Japan"]},{"name":"Department of Urology, The Jikei University Katsushika Medical Center , 6-41-2 Aoto, Katsushika-ku, Tokyo 125-0062 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5468-7632","authenticated-orcid":false,"given":"Takashige","family":"Abe","sequence":"additional","affiliation":[{"name":"Department of Renal and Genitourinary Surgery, Graduate School of Medicine, Hokkaido University , Kita 15-jo Nishi 7-chome, Kita-ku, Sapporo-shi, Hokkaido 060-8638 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shotaro","family":"Nakanishi","sequence":"additional","affiliation":[{"name":"Department of Urology, Graduate School of Medicine, University of the Ryukyus , 1076 Kiyuna, Ginowan-shi, Okinawa 901-2720 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3031-7258","authenticated-orcid":false,"given":"Katsuyoshi","family":"Hashine","sequence":"additional","affiliation":[{"name":"Department of Urology, National Hospital Organization Shikoku Cancer Center , Ko 160 Minami-Umemotocho, Matsuyama-shi, Ehime 791-0280 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masato","family":"Fujii","sequence":"additional","affiliation":[{"name":"Department of Urology, Faculty of Medicine, University of Miyazaki , 5200 Kihara, Kiyotake-cho, Miyazaki-shi, Miyazaki 889-1692 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kiyoaki","family":"Nishihara","sequence":"additional","affiliation":[{"name":"Department of Urology, Kurume University School of Medicine , 67 Asahimachi, Kurume-shi, Fukuoka 830-0011 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9279-3156","authenticated-orcid":false,"given":"Keita","family":"Kobayashi","sequence":"additional","affiliation":[{"name":"Department of Urology, Graduate School of Medicine, Yamaguchi University , 1-1-1 Minami-Kogushi, Ube-shi, Yamaguchi 755-8505 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuichi","family":"Tatarano","sequence":"additional","affiliation":[{"name":"Department of Urology, Graduate School of Medical and Dental Sciences, Kagoshima University , 8-35-1 Sakuragaoka, Kagoshima-shi, Kagoshima 890-0075 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Koichiro","family":"Wada","sequence":"additional","affiliation":[{"name":"Department of Urology, Faculty of Medicine, Shimane University , 89-1 Enyacho, Izumo-shi, Shimane 693-8501 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930-0194 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroyuki","family":"Nishiyama","sequence":"additional","affiliation":[{"name":"Department of Urology, Faculty of Medicine, University of Tsukuba , 2-1-1 Amakubo, Tsukuba-shi, Ibaraki 305-0005 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroshi","family":"Kitamura","sequence":"additional","affiliation":[{"name":"Department of Urology, Faculty of Medicine, University of Toyama , 2630 Sugitani, Toyama-shi, Toyama 930-0194 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9841-0857","authenticated-orcid":false,"given":"Haruki","family":"Kume","sequence":"additional","affiliation":[{"name":"Department of Urology, Graduate School of Medicine, The University of Tokyo , 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"the 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