Outcomes of Partial and Radical Nephrectomy in Octogenarians – A Multicenter International Study (Resurge)

Published on Jul 1, 2019in Urology1.924
· DOI :10.1016/J.UROLOGY.2019.03.009
Alessandro Antonelli30
Estimated H-index: 30
(University of Brescia),
Alessandro Veccia10
Estimated H-index: 10
(University of Brescia)
+ 42 AuthorsRiccardo Autorino68
Estimated H-index: 68
OBJECTIVE: To analyze the outcomes of partial nephrectomy (PN) and radical nephrectomy (RN) in octogenarian patients. METHODS: The RESURGE (REnal SUrgery in the Eldely) multi-institutional database was queried to identify patients ≥80 years old who had undergone a PN or RN for a renal tumor. Multivariable binary logistic regression estimated the association between type of surgery and occurrence of complications. Multivariable Cox regression model assessed the association between type of surgery and All-Causes Mortality. RESULTS: The study analyzed 585 patients (median age 83 years, IQR 81-84), 364 of whom (62.2%) underwent RN and 221 (37.8%) PN. Patients undergoing RN were older (P = .0084), had larger tumor size (P 25%) decrease of eGFR in PN and RN was 18% versus 59% at 1 month, and 23% versus 65% at 6 months (P < .0001). After a median follow-up time of 39 months, 161 patients (31%) died, of whom 105 (20%) due to renal cancer. CONCLUSION: In this patient population both RN and PN carry a non-negligible risk of complications. When surgical removal is indicated, PN should be preferred, whenever technically feasible, as it can offer better preservation of renal function, without increasing the risk of complications. Moreover, a minimally invasive approach should be pursued, as it can translate into lower surgical morbidity.
#1Umberto Capitanio (UniSR: Vita-Salute San Raffaele University)H-Index: 62
#2Karim Bensalah (University of Rennes)H-Index: 64
Last. Paul Russo (MSK: Memorial Sloan Kettering Cancer Center)H-Index: 102
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Abstract Context Despite the improvement in renal cell carcinoma (RCC) diagnosis and management observed during the last 2 decades, RCC remains one of the most lethal urological malignancies. With the expansion of routine imaging for many disorders, an increasing number of patients who harbour RCC are identified incidentally. Objective To summarise and compare RCC incidence and mortality rates, analyse the magnitude of risk factors, and interpret these epidemiological observations in the context...
275 CitationsSource
#1Victoria White (Deakin University)H-Index: 51
#2David J. T. Marco (University of Melbourne)H-Index: 6
Last. Susan J. Jordan (UQ: University of Queensland)H-Index: 30
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To describe the use of partial nephrectomy (PN) for patients with stage T1a renal cell carcinoma (RCC) by age group ( All adults diagnosed with RCC in 2012 and 2013 were identified through population-based cancer registries in the Australian states of Queensland and Victoria. For each patient, research assistants extracted patient, tumour and treatment data from medical records. Percentages treated by PN were determined for the two age groups. Multivariable logistic regression analyses examined ...
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#1Alessandro Antonelli (University of Brescia)H-Index: 30
#2Andrea Mari (UniFI: University of Florence)H-Index: 31
Last. Filiberto ZattoniH-Index: 28
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#2Walter M. Stadler (U of C: University of Chicago)H-Index: 104
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Abstract The Tumor-Node-Metastasis (TNM) classification on cancer staging, jointly developed by the American Joint Commission on Cancer (AJCC) and the Union for International Cancer Control (UICC), has been updated to its 8th edition with two contemporaneous versions published by the AJCC and UICC. While the goal of the AJCC and UICC is to have identical TNM staging systems, differences exist between these two publications including in the staging of urologic cancers. Among several new facets in...
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#1Marco Bandini (UniSR: Vita-Salute San Raffaele University)H-Index: 24
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Introduction: Contemporary data regarding the effect of age, especially in elderly patients, on cancer-specific mortality (CSM) for pT1a renal cell carcinoma (RCC) are lacking. The objective of the current study is to evaluate CSM in a large population-based cohort of surgically treated pT1a RCC patients according to age groups. Methods: Within the Surveillance Epidemiology and End Results database (2000‒2013), we identified 37 121 pT1a RCC patients who underwent either partial or radical nephre...
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#2Tommaso SilvestriH-Index: 6
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#2Jude NawloH-Index: 1
Last. Philippe E. SpiessH-Index: 35
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#1Emil Scosyrev (URMC: University of Rochester Medical Center)H-Index: 3
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Last. Hendrik Van Poppel (Katholieke Universiteit Leuven)H-Index: 82
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#1Daniel C. Wang (State University of New York Upstate Medical University)H-Index: 1
#2Kyle Plante (State University of New York Upstate Medical University)H-Index: 3
Last. Gennady Bratslavsky (State University of New York Upstate Medical University)H-Index: 21
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#2Sophie Knipper (UdeM: Université de Montréal)H-Index: 11
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#1Alessandro Veccia (University of Brescia)H-Index: 10
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