Surgical treatment of renal-cell carcinoma in elderly people
Por:
Rodríguez-Covarrubias F., Rivera-Ramirez J.A., Gabilondo-Pliego B., Castillejos-Molina R.A., Sotomayor M., Feria-Bernal G., Gabilondo-Navarro F.
Publicada:
1 ene 2016
Categoría:
Urology
Resumen:
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. © 2016 AEU
Filiaciones:
Rodríguez-Covarrubias F.:
Departamento de Urología, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Ciudad de México, Mexico
Rivera-Ramirez J.A.:
Departamento de Urología, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Ciudad de México, Mexico
Gabilondo-Pliego B.:
Departamento de Urología, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Ciudad de México, Mexico
Castillejos-Molina R.A.:
Departamento de Urología, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Ciudad de México, Mexico
Sotomayor M.:
Departamento de Urología, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Ciudad de México, Mexico
Feria-Bernal G.:
Departamento de Urología, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Ciudad de México, Mexico
Gabilondo-Navarro F.:
Departamento de Urología, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Ciudad de México, Mexico
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