ISSN: 0034-8376
eISSN: 2564-8896
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Abstract

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

VOLUME - NUMBER / (Forthcoming Articles)

Adrián M. Garza-Gangemi, Oncology Surgery Unit, Department of Surgery, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, México
Ricardo A. Castillejos-Molina, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
Guillermo Gueglio, Hospital Italiano, Buenos Aires, Argentina
Ignacio P. Tobia-Gonzalez, Hospital Italiano, Buenos Aires, Argentina
Alberto M. Jurado, Hospital Italiano, Buenos Aires, Argentina
Luis Meza-Montoya, Instituto Nacional de Enfermedades Neoplásicas, Lima, Peru
Carlos H. Scorticati, Hospital de Clínicas, Buenos Aires, Argentina
Walter Henriques-da-Costa, A.C. Camargo Cancer Center, Sao Paulo, Brazil
Juan Yandian, Hospital de Clínicas, Montevideo, Uruguay
Luis Ubillos, Hospital de Clínicas, Montevideo, Uruguay
Sidney Glina, Escuela de Medicina ABC, Sao Paulo, Brazil
Marcos Tobias-Machado, Escuela de Medicina ABC, Sao Paulo, Brazil
Oscar Rodríguez-Faba, Fundación Puigvert, Barcelona, Spain
Carlos Ameri, Hospital Alemán, Buenos Aires, Argentina
Alejandro Nolazco, Hospital Británico, Buenos Aires, Argentina
Pablo Martinez, Hospital Británico, Buenos Aires, Argentina
Gustavo Franco Carvalhal, School of Medicine, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, Brazil
Ruben G. Bengio, Clínica Profesor Bengio, Cordoba, Argentina
Leandro Cristian Arribillaga, Clínica Profesor Bengio, Cordoba, Argentina
Raúl Langenhin, Corporación Médica de Paysandú (COMEPA), Paysandu, Uruguay
Diego Muguruza, Corporación Médica de Paysandú (COMEPA), Paysandu, Uruguay
José G. Campos-Salcedo, Hospital Central Militar, Mexico City, Mexico
Edgar I. Bravo-Castro, Hospital Central Militar, Mexico City, Mexico
Pablo A. Mingote, Policlinico Neuquén, Neuquén, Argentina
Nicolás Ginestar, Policlinico Neuquén, Neuquén, Argentina
Ana M. Autran-Gomez, Hospital Fundación Jiménez Díaz, Madrid, Spain
Roberto Puente, Hospital de Clínicas, Montevideo, Uruguay
Ricardo Decia, Hospital de Clínicas, Montevideo, Uruguay
Gustavo Cardoso-Guimarães, A.C. Camargo Cancer Center, Sao Paulo, Brazil
Joan Palou-Redorta, Fundación Puigvert, Barcelona, Spain
Diego Abreu-Clavijo, Hospital Pasteur, Montevideo, Uruguay
Stenio de-Cassio-Zequi, A.C. Camargo Cancer Center, Sao Paulo, Brazil
Francisco T. Rodriguez-Covarrubias, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
On Behalf of the Latin American Renal Cancer Group (LARCG),

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.

Keywords: Kidney cancer. Elderly. Nephrectomy. Latin America. Surgical Complications. Surgical outcomes.

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