Non-Muscle-Invasive Bladder Cancer in the Elderly Patient

With increasing life expectancy, both the incidence and the prevalence of bladder cancer (BC) are steadily rising. As over 70 % of newly diagnosed cases are non-muscleinvasive BC (NMIBC), the management of this entity plays a growing role. Clinical decision-making obviously involves age as an essential variable, but there are no evidence-based recommendations for healthcare professionals that stratify diagnosis, staging or therapy based on age. Data suggest that elderly patients are more frequently diagnosed with high stage and high grade NMIBC, and have worse recurrence and progression rates than younger patients. Moreover, elderly patients face both clinical and institutional barriers to appropriate evidence- based treatment; i.e. they are less likely to undergo re-resections, intravesical instillations and early radical cystectomy. Careful patient selection, and treatment algorithms tailored to the needs and the physiological and physical reserve of the individual patient are particularly important. Interdisciplinary collaborative efforts should focus to provide tailored geriatric care for all elderly patients with NMIBC.