Mp70-20 renal lesions in the 80 and over age group - targeted treatment and outcomes by pooled and signatured approach in a u.k. tertiary referral renal cancer center

You have accessJournal of UrologyKidney Cancer: Surgical Therapy V1 Apr 2015MP70-20 RENAL LESIONS IN THE 80 AND OVER AGE GROUP - TARGETED TREATMENT AND OUTCOMES BY POOLED AND SIGNATURED APPROACH IN A U.K. TERTIARY REFERRAL RENAL CANCER CENTER Sashi Kommu, Prasanna Sooriakumaran, Robert Mcarthur, Rajesh Nair, Meghana Kulkarni, Eleni Anastasiadis, A. Pai, Pieter le Roux, and Christopher Anderson Sashi KommuSashi Kommu More articles by this author , Prasanna SooriakumaranPrasanna Sooriakumaran More articles by this author , Robert McarthurRobert Mcarthur More articles by this author , Rajesh NairRajesh Nair More articles by this author , Meghana KulkarniMeghana Kulkarni More articles by this author , Eleni AnastasiadisEleni Anastasiadis More articles by this author , A. PaiA. Pai More articles by this author , Pieter le RouxPieter le Roux More articles by this author , and Christopher AndersonChristopher Anderson More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.02.2545AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES The treatment of renal lesions in the aging population continues to present challenges both from an individualised signatured approach and from a health burden point of view. Recent advances in minimally invasive approaches challenged previous age related bias in deciphering optimal treatment strategies in this population. However, the risk to benefit ratio of surgical treatment of renal lesions in patients aged 80 and over has not been objectively and comprehensively quantified. Herein, we share our experience with the management of this challenging stratum of patients. METHODS Between Sept. 1989 to Oct. 2014 we performed. 1,100 procedures targeted at renal lesions in a United Kingdom tertiary referral renal cancer center. Data were tallied and interrogated for demographic and outcome parameters. Full comprehensive data was available for 1,084 cases (98.5%). Of this, we selected those aged 80 and over for the present analysis (n=85;8%). RESULTS The median age of the study population (n=1,084) was 63yrs [range 16-92yrs; IQR: 53-73; Male(M)=66%, Female(F)=34%]. Group A(GpA) consisted of patients under 80 years of age [92%] and Group B(GpB) consisted of 80 and over age group (n=85; 8%);[M=60%:F=40%(IQR:81-85)]. From GpB, 84% had procedures for malignant disease and 16% had benign disease. Median American Society of Anaesthesiologists (ASA) score of 2.0. Procedures carried out in GpB included Laparoscopic(Lap) Radical Nephrectomy=14/151(9%); Hand Assisted Lap (HAL) Radical Nephrectomy=8/94 (9%); Lap Nephroureterectomy=17/70(24%); Open Nephroureterectomy=7/30(23%);HAL Nephroureterectomy=2/8 (25%);Open Simple Nephrectomy=1/16(6%);Open Radical Nephrectomy=15/287(5%);Open Partial Nephrectomy=3/185(2%);Robot Assisted Partial Nephrectomy=3/98(3%) and Cryotherapy(Percutaneous and Lap=13/84(15%)]. Overall postoperative length of hospital stay was [GpA =6 days (1-91) vs. GpB =6 days (2-31). Clavien Dindo (CD) score in GpA versus GpB was CD1(A=34%vs. B=32%); CD2(A=25%vs.B=24%); CD3(A=7.0%vs.B=5.0%); CD5(A=1%vs.B=1%). In GpA, at a median follow-up of 27 months(1-287), 79% were alive and disease free. In GpB, at a median follow-up of 13 months (1-165), 78% were alive and disease free revealing no significant outcome differences between GpA and GpB. CONCLUSIONS In patients 80 and over with renal lesions, favourable outcomes can be achieved in dedicated tertiary referral renal cancer centers. In our study when evaluating comparable goups, favourable outcomes were achieved in the 80 and and over age group on par with the under 80 age group. Therefore, the risk to benefit ratio should be weighed carefully and age should not be considered a barrier to intervention. © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 193Issue 4SApril 2015Page: e885 Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.MetricsAuthor Information Sashi Kommu More articles by this author Prasanna Sooriakumaran More articles by this author Robert Mcarthur More articles by this author Rajesh Nair More articles by this author Meghana Kulkarni More articles by this author Eleni Anastasiadis More articles by this author A. Pai More articles by this author Pieter le Roux More articles by this author Christopher Anderson More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...