title: Overall mortality after radical nephrectomy in patients aged over 80 years with renal cancer: a retrospective study on preoperative prognostic factors.
abstract: OBJECTIVE
  To evaluate the overall survival postnephrectomy for renal cancer for patients aged over 80 years, and to identify preoperative prognostic factors that might influence therapeutic strategies.
  
  
  METHODS
  In a retrospective study in five French departments of urology, 179 patients aged over 80 years with renal cell carcinoma underwent radical nephrectomy between 1990 and 2011. The following data were collected: age, sex, body mass index, Charlson Comorbidity Index, American Society of Anesthesiology class, Eastern Cooperative Oncology Group Performance Status, type of surgery, period of follow-up, survival, death etiology, symptoms, Fuhrman grade and tumor-nodes-metastasis stage.
  
  
  RESULTS
  After a 29.6-month follow up, 89 patients (49.7%) died. Death etiologies were: cancer for 46 (52%) patients, immediate or distant perioperative complications for five patients (6%) and three patients (3%) respectively, cardiovascular disease for 16 patients (18%), other cancers for three patients (3%) and unknown for 16 patients (18%). In a multivariate analysis, T-stage, M-stage and Charlson Comorbidity Index were identified as independent prognostic factors. Patients were divided into three groups (good, intermediate and bad prognosis) with significantly different survivals of 91, 36 and 22 months (P < 0.0001), respectively.
  
  
  CONCLUSIONS
  Preoperative data, including T-stage, M-stage and Charlson Comorbidity Index represent significant independent prognostic factors for survival for patients aged over 80 years. These data might help the clinician in selecting the most suitable candidates for radical nephrectomy among elderly patients with renal cancer.
authors.affiliation: Department of Urology, Angers University Hospital, France.
authors.forename: Elena
authors.initials: E
authors.lastname: Brassart
authors.forename: Souhil
authors.initials: S
authors.lastname: Lebdai
authors.forename: Julien
authors.initials: J
authors.lastname: Berger
authors.forename: Sory
authors.initials: S
authors.lastname: Traore
authors.forename: Jean-Christophe
authors.initials: JC
authors.lastname: Bernhard
authors.forename: Tarek
authors.initials: T
authors.lastname: Fardoun
authors.forename: Guillaume
authors.initials: G
authors.lastname: Muller
authors.forename: Jean-Jacques
authors.initials: JJ
authors.lastname: Patard
authors.forename: Abdel Rahmène
authors.initials: AR
authors.lastname: Azzouzi
authors.forename: Pierre
authors.initials: P
authors.lastname: Bigot
mesh_terms: D000369:Aged, 80 and over; D002292:Carcinoma, Renal Cell / Q000401:mortality* / Q000473:pathology / Q000601:surgery*; D015897:Comorbidity; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D007680:Kidney Neoplasms / Q000401:mortality* / Q000473:pathology / Q000601:surgery*; D008207:Lymphatic Metastasis; D008297:Male; D015999:Multivariate Analysis; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D009392:Nephrectomy; D016016:Proportional Hazards Models; D012189:Retrospective Studies