You have accessJournal of UrologyKidney Cancer: Localized IV1 Apr 20121678 PARTIAL NEPHRECTOMY IS NOT ASSOCIATED WITH AN OTHER-CAUSE MORTALITY BENEFIT IN PATIENTS AGED ≥75 YEARS AND/OR MULTIPLE COMORBIDITIES WITH SMALL RENAL MASSES Maxine Sun, Marco Bianchi, Quoc-Dien Trinh, Jens Hansen, Nawar Hanna, Zhe Tian, Shahrokh Shariat, Paul Perrotte, and Pierre Karakiewicz Maxine SunMaxine Sun Montreal, Canada More articles by this author , Marco BianchiMarco Bianchi Milan, Italy More articles by this author , Quoc-Dien TrinhQuoc-Dien Trinh Detroit, MI More articles by this author , Jens HansenJens Hansen Hamburg, Germany More articles by this author , Nawar HannaNawar Hanna Montreal, Canada More articles by this author , Zhe TianZhe Tian Montreal, Canada More articles by this author , Shahrokh ShariatShahrokh Shariat New York, NY More articles by this author , Paul PerrottePaul Perrotte Montreal, Canada More articles by this author , and Pierre KarakiewiczPierre Karakiewicz Montreal, Canada More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2012.02.1551AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Partial nephrectomy (PN) may protect against other-cause mortality (OCM) relative to radical nephrectomy (RN) in patients with localized renal cell carcinoma (RCC). However, this benefit may not be applicable to patients with advanced age and/or multiple baseline comorbidities. We sought to quantify the effect of treatment type on OCM amongst patients with these characteristics. METHODS Using the Surveillance, Epidemiology, and End Results Medicare-linked database, respectively 8736 (88%) and 1249 (12%) RN and PN patients with T1 RCC were identified (1988–2005). To adjust for inherent differences between treatment types, propensity-based matched analyses was performed. Univariable and multivariable competing-risks regression analyses for prediction of OCM were performed according to treatment type. Sub-analyses were conducted in patients aged >75 years and with >2 comorbidities. RESULTS Following propensity-based matched analyses, the 2- and 5-year OCM rates were 6.2 and 18.8% for RN vs. 6.1 and 17.3% for PN, respectively (P=0.28). Amongst patients aged >75 years, the 2- and 5-year OCM rates were 9.0 and 26.0% for RN vs. 9.7 vs. 27.7% for PN, respectively (P=0.42). For the same time points, in patients with >2 baseline comorbidities, the rates were 8.0 and 23.5% for RN vs. 7.5 and 20.2% for PN, respectively (P=0.19). Following adjustment for all covariates, no difference was recorded between PN and RN in the risk of OCM in the matched population (hazard ratio [HR] %0.92, 95% confidence interval [CI]: 0.79–1.06, P=0.25). Amongst patients aged >75 years (HR: 1.17, 95% CI: 0.94–1.48, P=0.16) and >2 baseline comorbidities (HR: 0.89, 95% CI: 0.75–1.05, P=0.17), no difference was recorded for treatment type. CONCLUSIONS While nephron-sparing has been associated with a protective effect on OCM, some elderly patients and/or those with multiple comorbidities at baseline may not benefit from PN. Amongst these patients, alternative treatment options may be recommended. © 2012 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 187Issue 4SApril 2012Page: e678 Advertisement Copyright & Permissions© 2012 by American Urological Association Education and Research, Inc.MetricsAuthor Information Maxine Sun Montreal, Canada More articles by this author Marco Bianchi Milan, Italy More articles by this author Quoc-Dien Trinh Detroit, MI More articles by this author Jens Hansen Hamburg, Germany More articles by this author Nawar Hanna Montreal, Canada More articles by this author Zhe Tian Montreal, Canada More articles by this author Shahrokh Shariat New York, NY More articles by this author Paul Perrotte Montreal, Canada More articles by this author Pierre Karakiewicz Montreal, Canada More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...