Surgical treatment of bladder cancer in the geriatric patients.

As bladder cancer is an age-related disease and an increase in patients with MIBC seems inevitable because of the aging population in Japan, muscle-invasive bladder cancer (MIBC) care in the elderly is likely to become a very common problem in daily practice. The gold standard for patients with MIBC is radical cystectomy (RC). However, elderly patients present with several comorbidities, and the geriatric patients with MIBC were not given po- tentially curative treatments, including RC. The optimal therapy for elderly MIBC patients may become a crucial issue. To achieve a better oncologic outcome in the neoadjuvant set- ting, the chemotherapy regimen should be less toxic to prevent any treatment-related delay between chemotherapy and RC. In addition, minimally invasive surgical approaches for the elderly patients with MIBC have been rapidly adopted for the treatment of MIBC, improving perioperative morbidity and ease of recovery.