[The symptomatic therapy of middle-aged and elderly kidney cancer patients. An alternative to surgical treatment?].
355 patients aged 60-90 received treatment for renal carcinoma: 207 underwent surgery, 148 were managed conservatively. Postoperative lethality made up 11.6%. Five-year survival reached 34.7% and 24.3% in surgical and conservative patients, respectively. The difference proved statistically insignificant, though conservative patients were much more serious both by the disease stage and somatic status. The surgery in 35.1% of them was rejected because of the advanced carcinoma stage, to 36.8% it was contraindicated due to intercurrent affections. The authors give their original point of view on therapeutic approach to renal carcinoma in aged subjects. They advocate wider use of conservative treatment in these cases as long-term results of conservative treatment are comparable to those of surgical one. The authors suggest to develop a special model permitting a case-by-case approach to choice of treatment for aged renal carcinoma patients. Such model can be developed basing on objective mathematical method which would be able to provide prognosis of survival by the results of the initial clinical examination of each patient.
Igel'nik
A M
AM
Popovkin
N N
NN
D000368:Aged; D000369:Aged, 80 and over; D002292:Carcinoma, Renal Cell / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D015897:Comorbidity; D000075202:Contraindications; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D009392:Nephrectomy / Q000401:mortality
Simptomaticheskaia terapiia bol'nykh rakom pochki pozhilogo i starcheskogo vozrasta. Al'ternativa operativnomu lecheniiu?