title: Surgical treatment of renal-cell carcinoma in elderly people.
abstract: OBJECTIVE
  To describe the oncological characteristics and evolution of patients 65 years or older who underwent surgery for renal-cell carcinoma (RCC).
  
  
  METHODS
  We reviewed our prospectively maintained database of patients with RCC treated surgically. Those ≥ 65 years old were selected. We analyzed clinical and pathological characteristics as well as oncological and functional outcomes. Overall survival (OS) was estimated with the Kaplan-Meier method. Multivariate Cox-proportional hazards model was used to determine predictors of OS.
  
  
  RESULTS
  A total of 156 elderly patients with mean age 72.0±5.5 years (range 65-92) and median follow-up of 33 months were included. Surgical approach was open radical nephrectomy in 114 (73.5%), laparoscopic radical nephrectomy in 13 (8.4%), open partial nephrectomy in 23 (14.2%) and laparoscopic partial nephrectomy in 6 (3.9%). Pathological stage was: Stage I, 71 (45.5%); Stage II, 27 (17.3%); Stage III, 48 (30.8%); and Stage IV, 10 (6.4%). Lastly, 51 (32.6%) patients died, 22 (43.1%) from cancer. The 5-year OS according to pathological stage was 77.6%, 71.9%, 45.1% and 11.7% for stage I, II, III and IV, respectively (P<.001). On multivariate analysis, pathological stage independently predicted OS (HR 1.96, 95% CI [1.36-2.84], P=.0003).
  
  
  CONCLUSIONS
  The surgical management of RCC appears to be safe in properly selected patients 65 years or older. Pathological stage predicts survival in this population.
authors.affiliation: Departamento de Urología, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubiran, Ciudad de México, México. Electronic address: francisco.rodriguezc@incmnsz.mx.
authors.forename: F
authors.initials: F
authors.lastname: Rodríguez-Covarrubias
authors.affiliation: Departamento de Urología, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubiran, Ciudad de México, México.
authors.forename: J A
authors.initials: JA
authors.lastname: Rivera-Ramirez
authors.affiliation: Departamento de Urología, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubiran, Ciudad de México, México.
authors.forename: B
authors.initials: B
authors.lastname: Gabilondo-Pliego
authors.affiliation: Departamento de Urología, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubiran, Ciudad de México, México.
authors.forename: R A
authors.initials: RA
authors.lastname: Castillejos-Molina
authors.affiliation: Departamento de Urología, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubiran, Ciudad de México, México.
authors.forename: M
authors.initials: M
authors.lastname: Sotomayor
authors.affiliation: Departamento de Urología, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubiran, Ciudad de México, México.
authors.forename: G
authors.initials: G
authors.lastname: Feria-Bernal
authors.affiliation: Departamento de Urología, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubiran, Ciudad de México, México.
authors.forename: F
authors.initials: F
authors.lastname: Gabilondo-Navarro
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002292:Carcinoma, Renal Cell / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D008297:Male; D009392:Nephrectomy / Q000379:methods*; D016016:Proportional Hazards Models; D012189:Retrospective Studies
keywords: Cáncer renal; Elderly; Kidney cancer; Latin America; Latinoamérica; Mexico; México; Nefrectomía; Nephrectomy; Tercera edad