OBJECTIVE: To determine whether age and comorbidity are predictors of peri-operative complications and/or mortality in surgery for renal cell cancer in a retrospective study of patients aged >75 years. PATIENTS AND METHODS: Between 1993 and 2003, 1023 radical nephrectomies or nephron-sparing surgery for renal cell cancer were performed in 115 consecutive patients aged > or = 75 years and in 908 consecutive patients aged <75 years. The preoperative American Society of Anesthesiologists (ASA) score was used for risk stratification. Operative mortality and early complications (within 30 days of surgery) were reviewed. RESULTS: The younger patients had significantly lower ASA scores than the older patients. There were early complications in 31 of the 908 younger patients (3.4%) and in two of the 115 older patients (1.7%). Peri-operative mortality was higher in the older than in the younger patients (1.7% vs 0.3%; P = 0.29). Overall morbidity and mortality correlated with increasing ASA score but not with age (P < 0.05). CONCLUSIONS: Despite greater comorbidity in older patients, their morbidity and mortality did not differ significantly from that of younger patients. Advanced age alone should thus not be used as a criterion to deny surgery for renal cell carcinoma. However, older patients should be counselled regarding a tendency for increased comorbidity-related peri-operative mortality.
OBJECTIVE: To determine whether age and comorbidity are predictors of peri-operative complications and/or mortality in surgery for renal cell cancer in a retrospective study of patients aged >75 years. PATIENTS AND METHODS: Between 1993 and 2003, 1023 radical nephrectomies or nephron-sparing surgery for renal cell cancer were performed in 115 consecutive patients aged > or = 75 years and in 908 consecutive patients aged <75 years. The preoperative American Society of Anesthesiologists (ASA) score was used for risk stratification. Operative mortality and early complications (within 30 days of surgery) were reviewed. RESULTS: The younger patients had significantly lower ASA scores than the older patients. There were early complications in 31 of the 908 younger patients (3.4%) and in two of the 115 older patients (1.7%). Peri-operative mortality was higher in the older than in the younger patients (1.7% vs 0.3%; P = 0.29). Overall morbidity and mortality correlated with increasing ASA score but not with age (P < 0.05). CONCLUSIONS: Despite greater comorbidity in older patients, their morbidity and mortality did not differ significantly from that of younger patients. Advanced age alone should thus not be used as a criterion to deny surgery for renal cell carcinoma. However, older patients should be counselled regarding a tendency for increased comorbidity-related peri-operative mortality.
Authors: Husain K Khambati; Toni K Choueiri; Christian K Kollmannsberger; Scott North; George A Bjarnason; Ulka N Vaishampayan; Lori Wood; Jennifer J Knox; Min-Han Tan; Mary J MacKenzie; Frede Donskov; Brian I Rini; Daniel Y C Heng Journal: Clin Genitourin Cancer Date: 2014-03-05 Impact factor: 2.872
Authors: Nicholas J Vogelzang; Sumanta K Pal; Sameer R Ghate; Elyse Swallow; Nanxin Li; Miranda Peeples; Miriam L Zichlin; Mark K Meiselbach; Jose Ricardo Perez; Neeraj Agarwal Journal: Adv Ther Date: 2017-10-26 Impact factor: 3.845