[Do ablative treatments modify the management of kidney tumors in the elderly?].
The development of ablative techniques in renal oncology has profoundly changed treatment of small renal tumors. The objective of this review of the literature was to assess the arguments for treating localized kidney tumors with these techniques in the elderly patient. The two techniques retained because of their recognized use, for all approaches, are radiofrequency and cryotherapy. The data in the literature report more frequent local recurrence with these techniques than with surgical excision and an advantage to cryotherapy over radiofrequency. There seems to be no difference in terms of metastatic progression. Morbidity is not insignificant, with major complications in slightly less than 10% of cases. Given the need to consider small tumors (<4 cm), the advantage in terms of life expectancy is challenged by series studying active monitoring of the oldest patients who present co-morbidities. At present, the indications should therefore be measured and based on a general assessment of the patient, with particular consideration of the existing co-morbidities so as not to treat a patient while imposing undue complications.
Long
J-A
JA
Service d'urologie, CHU de Grenoble, 38043 Grenoble cedex 9, France. jalong@chu-grenoble.fr
Neuzillet
Y
Y
Poissonnier
L
L
Lang
H
H
Paparel
P
P
Escudier
B
B
Rioux-Leclercq
N
N
Correas
J-M
JM
Mejean
A
A
Baumert
H
H
Soulié
M
M
Patard
J-J
JJ
D000368:Aged; D000369:Aged, 80 and over; D017115:Catheter Ablation / Q000379:methods; D017679:Cryotherapy / Q000379:methods; D006801:Humans; D007680:Kidney Neoplasms / Q000532:radiotherapy* / Q000601:surgery*; D008875:Middle Aged