Abstract
Objective:The feasibility of curative surgery for elderly patients with renal cell carcinoma (RCC) remains controversial and under discussion. The main aim of this study was to evaluate the long-term benefits of curative surgery as a treatment for RCC in elderly patients.Methods:We retrospectively considered 672 patients with RCC who underwent partial nephrectomy or radical nephrectomy between January 2004 and July 2014. X-tile program was used to determine the optimal age cutoff values with CSS as endpoint.Results:Patients were divided into the following groups according to their age using the method of X-tile program: a young group (< 40 years), a young-old group (40-75) and an old-old group (≥ 75). Following multivariate analysis age ≥ 75 years was determined to be an independent risk factor for overall survival (HR=4.36; 95% CI: 1.31-14.48; P=0.016); interestingly, this was not the case for cancer-specific survival (HR = 2.65; 95%CI: 0.77-9.16; P=0.124). Furthermore, an age of 40 to 75 years was not a risk factor according to univariate and multivariate analysis.Conclusion:After determining the age cutoff values, there was no significant difference in prognosis between young and old patients with RCC.
Highlights
Renal cell carcinoma (RCC) is well-known as the most common renal parenchymal malignancy, representing 2% to 3% of all cancers.[1]
We evaluate the clinicopathological features and survival outcomes of patients undergoing curative nephrectomy at different ages, in an attempt to find possible associated factors and appropriate age cut-off values to predict the prognosis of RCC patients after surgery
The tumor size was comparable among the three age groups (4.0, 4.3, and 4.3, respectively; p=0.172), patients aged ≥ 75 years old were more likely to undergo radical nephrectomy, rather than partial nephrectomy, as compared with young-old group or young group patients (85.4%, 76.8%, and 68.6%, respectively; p=0.021)
Summary
Renal cell carcinoma (RCC) is well-known as the most common renal parenchymal malignancy, representing 2% to 3% of all cancers.[1]. In spite of the advances that have been made in the understanding of RCC biology, surgery procedures, including radical nephrectomy or partial nephrectomy, remain the only curative treatment method for localized RCC patients.[1,7] Older patients
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