Research and Reports in Urology (Jul 2019)
Perioperative outcomes in elderly patients undergoing nephrectomy for renal cell carcinoma
Abstract
Wichien Sirithanaphol,1 Kachit Pachirat,1 Ukrit Rompsaithong,1 Pakorn Kiatsopit,1 Piti Ungareevittaya,2 Jarin Chindaprasirt31Division of Urologic Surgery, Department of Surgery, Khon Kaen University, Khon Kaen, Thailand; 2Department of Pathology, Khon Kaen University, Khon Kaen, Thailand; 3Medical Oncology Division, Department of Internal Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, ThailandPurpose: To determine if age should be considered a relative contraindication to surgery for safety reasons.Methods: Renal cell carcinoma (RCC) patients who underwent nephrectomy from January 2007 to December 2017 were analyzed retrospectively. Patients were grouped into age<65 and age≥65 years. The demographic data, surgical outcomes, complication, hospital stay, blood loss, and survival were compared between the two groups.Results: A total of 101 patients were included; 74 in the younger group, and 27 in the older group. Compared to the young group, lower BMI, higher anemia, higher ASA grade, and comorbidities were frequent in the elderly. The operative time, blood loss, and renal function decline were comparable between two age groups. The complication rates in the older and younger group were 22% and 12%, respectively. The survival time was shorter in older patients compared to the younger ones; hazard ratio 2.25; 95%CI 1.08–4.69, p-value=0.031.Conclusion: Nephrectomy in elderly patients is safe and feasible and preoperative assessment along with diligent postoperative care may further increase survival. Age alone cannot be regarded as a contraindication for nephrectomy in RCC.Keywords: geriatric, kidney cancer, kidney surgery, aged population
