Partial versus radical nephrectomy in very elderly patients: a propensity score analysis of surgical, functional and oncologic outcomes (RESURGE project)

Mir, Maria Carmen; Pavan, Nicola; Capitanio, Umberto; Antonelli, Alessandro; Derweesh, Ithaar; Rodríguez-Faba, Óscar; Linares, Estefanía; Takagi, Toshio; Rha, Koon Ho; Fiori, C.; Maurer, Tobias; Zang, Chao; Mottrie, Alexandre; Umari, Paolo; Long, Jean-Alexandre; Fiard, G.; Nunzio, Cosimo De; Tubaro, Andrea; Tracey, Andrew; Ferro, Matteo; Cobelli, Ottavio De; Micali, Salvatore; Bevilacqua, L.; Torres, João Pimentel; Schips, Luigi; Castellucci, Roberto; Dobbs, Ryan W.; Quarto, Giuseppe; Bove, Pierluigi; Celia, Antonio; Concilio, Bernardino De; Trombetta, Carlo; Silvestri, Tommaso; Larcher, Alessandro; Montorsi, Francesco; Palumbo, Carlotta; Furlan, Maria; Bindayı, Ahmet; Hamilton, Zachary; Breda, Alberto; Palou, Joan; Aguilera, Alfredo; Tanabe, Kazunari; Raheem, Ali Abdel; Amiel, Thomas; Yang, Bo; Lima, Estêvão; Crivellaro, Simone; Perdonà, Sisto; Gregorio, Caterina; Barbati, Giulia; Porpiglia, Francesco; Autorino, Riccardo

doi:10.1007/s00345-019-02665-2

Cited by 26 publications

(21 citation statements)

References 23 publications

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“…11 Conversely, Mir et al compared PN and RN in very elderly (>75 years) patients, and PN yielded a benefit with regard to cancer-specific mortality (HR: 0.19, 95% CI: 0.04-0.97; P = .05), but there was no significant benefit with regard to either overall mortality or non-cancer-specific mortality. 19 In agreement with these results, in our study, we did not find an association between age…”

Section: Discussionsupporting

confidence: 91%

“…Furthermore, Like et al showed that significant survival benefits were only seen in male patients < 75 years treated with PN ( P = .0005), and there was no significant difference between the groups among male patients > 75 years and female patients ( P = .736, P = .175 and P = .191, respectively) 11 . Conversely, Mir et al compared PN and RN in very elderly (>75 years) patients, and PN yielded a benefit with regard to cancer‐specific mortality (HR: 0.19, 95% CI: 0.04‐0.97; P = .05), but there was no significant benefit with regard to either overall mortality or non‐cancer–specific mortality 19 . In agreement with these results, in our study, we did not find an association between age (subgroups; <49, 50‐64 and >65 years) and OS.…”

Section: Discussionmentioning

confidence: 99%

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Factors affecting long‐term renal functions after partial vs radical nephrectomy for clinical T1 renal masses: A Multicentre Study of the Urooncology Association, Turkey

İzol

Gökalp

Sözen

et al. 2021

Int. J. Clin. Pract.

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The detection of early-stage localised T1 renal tumours has increased because of the widespread use of modern imaging procedures. This has led to higher utilisation of partial nephrectomy (PN), although radical nephrectomy (RN) remains the most commonly performed procedure for the excision of renal tumours. 1,2 According to the recent American and European guidelines, PN has become the standard treatment modality for T1 renal masses, and compared with RN, PN yields similar oncological results, superior preservation of renal function and minimisation of the long-term

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Factors affecting long‐term renal functions after partial vs radical nephrectomy for clinical T1 renal masses: A Multicentre Study of the Urooncology Association, Turkey

İzol

Gökalp

Sözen

et al. 2021

Int. J. Clin. Pract.

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“…A recent study where a propensity score analysis of surgical, functional, and oncologic outcomes was performed between 613 patients over 75 years of age compared to matched controls who underwent partial versus radical nephrectomy, found that partial nephrectomy in elderly patients with localized tumors did not compromise oncologic outcomes and allowed better functional preservation compared to radical nephrectomy during a 3-year follow-up. However, they reported a higher overall complication rate in the partial nephrectomy group (33% vs. 25%, p = 0.01) 17 .…”

Section: Discussionmentioning

confidence: 93%

Characteristics and Surgical Outcomes in Very Elderly Patients (>-75 years) with Renal Cell Carcinoma: Data from the Latin American Renal Cancer Group

Garza-Gangemi

Castillejos-Molina

Gueglio

et al. 2021

RIC

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Background: The incidence of renal cell carcinoma (RCC) is increasing globally due to an aging population and widespread use of imaging studies. Objective: The aim of this study was to describe the characteristics and perioperative outcomes of RCC surgery in very elderly patients (VEP), ≥ 75 years of age. Methods: This is a retrospective comparative study of 3656 patients who underwent the treatment for RCC from 1990 to 2015 in 28 centers from eight Latin American countries. We compared baseline characteristics as well as clinical and perioperative outcomes according to age groups (<75 vs. ≥75 years). Surgical complications were classified with the Clavien-Dindo score. We performed logistic regression analysis to identify factors associated with perioperative complications. Results: There were 410 VEP patients (11.2%). On bivariate analysis, VEP had a lower body mass index (p < 0.01) and higher ASA score (ASA >2 in 26.3% vs. 12.4%, p < 0.01). There was no difference in performance status and clinical stage between the study groups. There were no differences in surgical margins, estimated blood

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“…7 It is generally believed that compared with cRN, cPN can not only reduce tumor burden equally, 8 but also better protect renal function, reduce the occurrence of long-term cardiovascular diseases, and increase patients' tolerance to systemic therapy drugs, which is conducive to long-term survival. 9,10 However, the risks of increased perioperative complications and prolonged operative time are disturbing equally. Elderly metastatic renal cancer (EmRCC) is often considered to have a worse long-term survival and lower resistance to surgical risks; hence, it is directly abandoned for surgery or rarely considered for cPN treatment.…”

Section: Introductionmentioning

confidence: 99%

<p>The Effect of Cytoreductive Partial Nephrectomy in Elderly Patients with Metastatic Renal Cell Carcinoma</p>

Chen¹,

He²,

Liu³

et al. 2020

CIA

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Objective: To explore the survival value of cytoreductive partial nephrectomy (cPN) in elderly with metastatic renal cell carcinoma (EmRCC) and evaluate the characteristics of patients who benefit from cPN. Materials and Methods: This was a study including 6105 patients aged ≥65 years with metastatic renal cell carcinoma (RCC) queried from Surveillance, Epidemiology and End Results (SEER) database between 2010 and 2015, among which 1264 patients underwent cytoreductive nephrectomy (CN), 78 patients underwent cPN and 1186 patients underwent cytoreductive radical nephrectomy (cRN). Kaplan-Meier (K-M) method and Cox proportional-hazards model (COX) were used to evaluate the survival prognosis. Overall survival (OS) was compared between groups using propensity score matching (PSM) to balance the effects of confounding factors such as general features and pathological features. At last, we constructed a nomogram visualization modelled by R language to predict survival. Results: For patients with EmRCC, especially for male patients with tumors size ≤7 cm, N0 stage, or isolated metastases, cPN brought a better survival than cRN. Tumor size and N stage were independent risk factors affecting the survival of cPN patients. cPN for patients with tumor size >7 cm or N1 stage may present a higher risk of death. Conclusion:The implementation of cPN for patients with EmRCC who meet specific clinical characteristics such as tumors size ≤7 cm, N0 stage, or isolated metastases seems to help improve the survival prognosis.

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Partial versus radical nephrectomy in very elderly patients: a propensity score analysis of surgical, functional and oncologic outcomes (RESURGE project)

Cited by 26 publications

References 23 publications

Factors affecting long‐term renal functions after partial vs radical nephrectomy for clinical T1 renal masses: A Multicentre Study of the Urooncology Association, Turkey

Factors affecting long‐term renal functions after partial vs radical nephrectomy for clinical T1 renal masses: A Multicentre Study of the Urooncology Association, Turkey

Characteristics and Surgical Outcomes in Very Elderly Patients (>-75 years) with Renal Cell Carcinoma: Data from the Latin American Renal Cancer Group

<p>The Effect of Cytoreductive Partial Nephrectomy in Elderly Patients with Metastatic Renal Cell Carcinoma</p>

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