Robotic partial nephrectomy versus radical nephrectomy in elderly patients with large renal masses.
Publication Title
Minerva urologica e nefrologica = The Italian journal of urology and nephrology
Document Type
Article
Publication Date
9-13-2019
Abstract
BACKGROUND: Recent evidence suggests that the "oldest old" patients might benefit of partial nephrectomy (PN), but decisionmaking for this subset of patients is still controversial. Aim of this study is to compare outcomes of robotic partial (RPN) or radical nephrectomy (RRN) for large renal masses in patients older than 65 years.
METHODS: We identified 417 ≥65 years old patients who underwent robotic radical nephrectomy (RRN) or RPN for cT1b or ≥cT2 renal mass at 17 high volume centers. Propensity score match analysis was performed adjusting for age, ASA≥3, pre-operative eGFR, and clinical tumor size. Predictors of complications, functional and oncological outcomes were evaluated in multivariable logistic and Cox regression models.
RESULTS: After propensity score analysis, 73 patients in the RPN group were matched with 74 in the RRN group. R.E.N.A.L. Score (9.6±1.7 vs 8.6±1.7; p
CONCLUSIONS: RPN In elderly patientswith large renal masses provides RPN offers acceptable surgical, and oncological outcomes allowing better functional preservation relative to RRN. The decision to undergo RPN in this subset of patients should be tailored on a case by case basis.
Clinical Institute
Kidney & Diabetes
Specialty/Research Institute
Nephrology
Specialty/Research Institute
Geriatrics
Specialty/Research Institute
Urology
