Renal tumour surgery in elderly patients.
OBJECTIVE
To analyse morbidity, renal function and oncological outcome in patients aged >or=80 years who had surgery for renal tumours, as in the elderly such surgery is controversial in relation to life-expectancy and other causes of death.


METHODS
Between 1990 and 2006, in our institution 1625 patients had surgery to treat solid renal tumours suspected to be renal cell carcinoma (RCC); 62 (4%) were aged >or=80 years (mean 82.5), and 73% of these elderly patients had radical nephrectomy (RN) and 27% nephron-sparing surgery (NSS).


RESULTS
The median (range) follow-up was 3.1 (0.2-14.1) years (89% of the patients). There was no perioperative mortality. There were only minor complications in 47% of patients, most (34%) being temporary increases in serum creatinine level. Histopathologically, 10% of the 62 patients had benign lesions and 90% had RCC. Of the 56 patients with RCC, the stage was pT1a in 34%, pT1b in 25%, pT2 in 5% and pT3 in 36%. For those treated with RN the median (range) serum creatinine level before and after RN was 1.0 (0.7-1.8) and 1.4 (1.0-2.8) mg/dL (P < 0.05), and for those treated with NSS were 1.1 (0.7-4.4) and 1.2 (0.7-4.8) mg/dL (not significant), respectively. The 5-year overall survival was 68% and the cancer-specific survival was 85%.


CONCLUSIONS
Surgery for renal tumours is safe in elderly patients, with a low perioperative morbidity and a good overall survival rate. Patients should be selected carefully according to comorbidities, biological age and social support.
Roos
Frederik C
FC
Department of Urology, Johannes Gutenberg-University, Medical School, Mainz, Germany. frederik.roos@gmx.de
Pahernik
Sascha
S
Melchior
Sebastian W
SW
Thüroff
Joachim W
JW
D000367:Age Factors; D000369:Aged, 80 and over; D002292:Carcinoma, Renal Cell / Q000401:mortality / Q000601:surgery*; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007680:Kidney Neoplasms / Q000401:mortality / Q000601:surgery*; D008297:Male; D009367:Neoplasm Staging; D009392:Nephrectomy / Q000009:adverse effects / Q000379:methods* / Q000592:standards; D011183:Postoperative Complications / Q000209:etiology* / Q000401:mortality; D011379:Prognosis; D012189:Retrospective Studies; D016019:Survival Analysis; D016896:Treatment Outcome