VEP (25.4% vs. 20.7%, p<0.04). Laparoscopic approach was more frequent in the VEP (43.2% vs. 37%, p<0.04). Partial nephrectomy and lymphadenectomy were performed less frequently in the older group (p<0.01, and p<0.02, respectively); there were no differences in surgical time, surgical margins, estimated blood loss (EBL), blood transfusions or complication rates. Length of stay was slightly longer in the VEP (4AE4 vs. 4AE3 days, p<0.01). On multivariate regression analysis, EBL!500cc (OR 2.06, CI 95% 1.36-3.11, p<0.00) was independently associated with perioperative complications.CONCLUSIONS: Despite VEP having more comorbidities, worse performance status and more pT3-4 tumors, surgical resection of RCC is a safe and successful intervention in this subgroup. Perioperative outcomes are similar to their younger counterparts. Age alone should not guide decision making in these patients and treatment must be tailored according to performance status and severity of other comorbidities.