Abstract
Background
This study aimed to evaluate the overall survival (OS) rate and renal function after
radical nephrectomy (RN) and partial nephrectomy (PN) in patients aged ⩾65 years.
Methods
Patients who underwent RN (n = 622) or PN (n = 622) for renal cell carcinoma (pT1N0M0) between 1999 and 2011 were propensity-score
matched in our multicentre database. To investigate the relative effect of PN on OS
according to age, we divided the patients into two age subgroups (<65 and ⩾65 years). The 5-year OS rates and probabilities of freedom from chronic kidney disease
(CKD III or IV) were estimated using the Kaplan–Meier method and separate Cox proportional
hazards models.
Results
The 5-year OS rates after surgery were 94.7% for PN and 91.9% for RN in the older
patients (P = 0.698). The corresponding rates in the younger patients were 99.7% for PN and 96.3%
for RN (P = 0.015). In separate Cox hazards models for OS, the older patients who underwent PN
were not significantly different from their RN-treated counterparts (hazard ratio
(HR): 0.960; 95% confidence interval (CI): 0.277–2.321, P = 0.797). Kidney function was significantly better preserved after PN than after RN
at all ages. However, stage IV CKD in the older patients did not occur more frequently
in the RN arm than in the PN arm.
Conclusions
Although PN was associated with improved renal function compared with RN, it did not
confer a benefit of higher survival rate in elderly patients (⩾65 years old).
Keywords
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Article info
Publication history
Published online: January 06, 2015
Accepted:
December 14,
2014
Received in revised form:
December 1,
2014
Received:
October 6,
2014
Identification
Copyright
© 2014 Elsevier Ltd. Published by Elsevier Inc. All rights reserved.
