NEW YORK (Reuters Health) – Surgery appears to be safe option in treatment of certain elderly patients with renal tumors, German researchers report in the September issue of BJU International

However, lead investigator Dr. Frederik C. Roos told Reuters Health, “The treatment certainly depends on a patient’s health, fitness and wishes. If the patient wants to undergo surgery, according to our results, it is a possible and safe procedure in carefully selected cases.”

Dr. Roos and colleagues at Johannes Gutenberg-University, Mainz examined data on 1625 patients who had undergone surgery at their institution because of solid tumors suspected to be renal cell carcinoma.

In all, 62 of the patients were more than 80 years old; 45 underwent radical nephrectomy and the remaining 17 had nephron-sparing surgery.

There was no perioperative mortality. While 56 of the patients were found to have renal cell carcinoma, 6 had benign lesions.

Those who underwent nephron-sparing surgery tended to have fewer complications. However, complications, mainly temporary increases in serum creatinine levels, were minor.

The 5-year overall survival was 68% and the cancer-specific survival was 85%. The median overall survival was 7.4 years for all patients. Median survival for those with renal cell carcinoma had not been reached at the time of last follow-up.

“Despite the excellent outcome,” say the investigators “an evaluation of comorbidity before surgery, with appropriate perioperative monitoring, remains mandatory.”

“And, of course,” added Dr. Roos, “there are other treatment options like surveillance or ablative procedures such as radio frequency ablation or cryosurgery — especially for this age group. These have to be discussed with the patient regarding their benefits and outcomes.”

Reference:
BJU Int 2008;102:680-683.