Improved outcome seen with partial rather than radical nephrectomy
Monday, February 21, 2011 (Last Updated: 02/22/2011)
MONDAY, Feb. 21 (HealthDay News) -- Older patients are less likely to die of renal cell carcinoma when treated with partial nephrectomy; however, they are less likely to undergo partial nephrectomy than are younger patients, according to a study published in the February issue of The Journal of Urology.
Nicholas J. Hellenthal, M.D., from the Roswell Park Cancer Institute in Buffalo, N.Y., and colleagues identified 59,944 patients who underwent partial or radical nephrectomy for renal cell carcinoma between 1988 and 2005. Patients were separated into two groups: younger than 80 and 80 years or older. A total of 4,227 patients were 80 years or older. Analyses were carried out to determine the association between surgical approach and overall and cancer-specific survival.
The investigators found that younger patients were significantly more likely to undergo partial nephrectomy than were older patients. At an average follow-up of 37 months for younger patients and 27 month for older patients, older patients were 2.32 times more likely to die and 1.33 times more likely to die of renal cell carcinoma than were younger patients. Older patients who underwent radical nephrectomy were 2.54 times more likely to die of renal cell carcinoma than were those who underwent partial nephrectomy.
"Surgical standards of care should include partial nephrectomy in appropriately selected octogenarians, and patients should be counseled accordingly," the authors write.
Hematology & Oncology
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