Characteristics and Surgical Outcomes in Very Elderly Patients (≥75 years) with Renal Cell Carcinoma: Data from the Latin American Renal Cancer Group
Título del documento: Characteristics and Surgical Outcomes in Very Elderly Patients (≥75 years) with Renal Cell Carcinoma: Data from the Latin American Renal Cancer Group
Revista: Revista de investigación clínica
Base de datos: PERIÓDICA
Número de sistema: 000453200
ISSN: 0034-8376
Autores: 1
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Instituciones: 1Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Ciudad de México. México
2Hospital Pasteur, Montevideo. Uruguay
3Centro de Cancer A.C. Camargo, Sao Paulo. Brasil
4Hospital Italiano de Buenos Aires, Buenos Aires. Argentina
5Instituto Nacional de Enfermedades Neoplásicas, Lima. Perú
6Hospital de Clínicas, Buenos Aires. Argentina
7Hospital de Clínicas, Montevideo. Uruguay
8Faculdade de Medicina do ABC, Sao Paulo. Brasil
9Fundación Puigvert, Barcelona. España
10Hospital Alemán, Buenos Aires. Argentina
11Hospital Británico de Buenos Aires, Buenos Aires. Argentina
12Pontificia Universidade Catolica do Rio Grande do Sul, Faculdade de Medicina, Porto Alegre, Rio Grande do Sul. Brasil
13Clínica Profesor Bengio, Córdoba. Argentina
14Corporación Médica de Paysandú, Paysandú. Uruguay
15Hospital Central Militar, Ciudad de México. México
16Policlinico Neuquén, Neuquén. Argentina
17Hospital Fundación Jiménez Díaz, Madrid. España
Año:
Periodo: Sep-Oct
Volumen: 72
Número: 5
Paginación: 308-315
País: México
Idioma: Inglés
Tipo de documento: Artículo
Enfoque: Analítico, descriptivo
Resumen en inglés 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 loss (EBL), complication, and mortality rates (1.3% vs. 0.4%, p = 0.17). On multivariate regression analysis, age ≥75 years (odds ratio [OR] 2.33, p < 0.01), EBL ≥ 500 cc (OR 3.34, p < 0.01), and > pT2 stage (OR 1.63, p = 0.04) were independently associated with perioperative complications. Conclusions: Surgical resection of RCC was safe and successful in VEP. Age ≥75 years was independently associated with 30-day perioperative complications. However, the vast majority were low-grade complications. Age alone should not guide decision-making in these patients, and treatment must be tailored according to performance status and severity of comorbidities. (REV INVEST CLIN. 2020;72(5):308-15)
Disciplinas: Medicina
Palabras clave: Nefrología,
Cirugía,
Oncología,
Geriatría,
Carcinoma de células renales,
Ancianos,
Nefrectomía,
Complicaciones quirúrgicas
Keyword: Nephrology,
Surgery,
Oncology,
Geriatrics,
Renal cells carcinoma,
Aged,
Nephrectomy,
Surgical complications
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