Lv Jinnv, Song Ruifang, Cai Hairong, Lu Chan
Ruian People's Hospital, Ruian, Zhejiang Province 325200, People's Republic of China.
J BUON. 2019 Sep-Oct;24(5):2147-2154.
This study was to compare the short- and long-term outcomes of elderly versus middle-aged patients with localized renal cell carcinoma who had undergone laparoscopic radical nephrectomy.
Between January 2012 and January 2018, a total of 54 patients aged 70 years and above with localized renal cell carcinoma (elderly group) underwent laparoscopic radical nephrectomy. The short- and long-term outcomes of these 54 patients were compared with those of 97 middle-aged patients (aged between 55 and 69 years; middle-aged group) who underwent laparoscopic radical nephrectomy due to localized renal cell carcinoma.
The age, Charlson's comorbidity index, and American Society of Anesthesiologists (ASA) score were higher in the elderly group than in the middle-aged group. Other preoperative baseline data did not show any statistically significant differences. The differences in short-term outcomes, including operative time, intraoperative blood loss, transfer rate, postoperative 30-day complication rate and severity of complication, and pathological data were not statistically significant between the elderly and middle-aged groups. Long-term follow-up results showed that the tumor recurrence rates were similar in the two groups. Overall and disease-free survival rates were similar in the two groups. Multivariate analysis showed that age was not an independent predictor for overall and disease-free survival rates.
Treatment with laparoscopic radical nephrectomy for elderly patients with localized renal cell carcinoma, could achieve short- and long-term outcomes, similar to those of middle-aged patients.
本研究旨在比较接受腹腔镜根治性肾切除术的老年与中年局限性肾细胞癌患者的短期和长期预后。
2012年1月至2018年1月期间,共有54例70岁及以上的局限性肾细胞癌患者(老年组)接受了腹腔镜根治性肾切除术。将这54例患者的短期和长期预后与97例因局限性肾细胞癌接受腹腔镜根治性肾切除术的中年患者(年龄在55至69岁之间;中年组)的预后进行比较。
老年组的年龄、查尔森合并症指数和美国麻醉医师协会(ASA)评分均高于中年组。其他术前基线数据未显示任何统计学上的显著差异。老年组和中年组在短期预后方面的差异,包括手术时间、术中出血量、中转率、术后30天并发症发生率及并发症严重程度,以及病理数据,均无统计学意义。长期随访结果显示,两组的肿瘤复发率相似。两组的总生存率和无病生存率相似。多因素分析表明,年龄不是总生存率和无病生存率的独立预测因素。
对于老年局限性肾细胞癌患者,腹腔镜根治性肾切除术的治疗可取得与中年患者相似的短期和长期预后。