Radical nephrectomy and nephroureterectomy in patients over 80 years old

Abstract

Purpose: The aim of this study was to discover if elderly patients exhibit comparable outcomes and survival benefits to those achieved in younger patients. Materials and Methods:We assessed 35 patients over 80 years old treated by radical nephrectomy or nephroureterectomy for malignant and inflammatory conditions within the previous 4 years. A multivariate analysis regarding survival and recovery was conducted and included various preoperative parameters. The subjective opinion of patients or patient's relatives (in cases where the patient had past away) was estimated by answering the following questions: (a) are you satisfied with your decision to undergo the operation? (b) would you undergo it once more if needed? (c) would you advise it to a patient your age? Results: The median age was 83.5 years. Radical nephrectomy with a flank approach was performed in 65.7% of cases and nephroureterectomy with a transabdominal approach in 34.3% of cases. The median recovery was 13 weeks. During a median follow-up of 31 months (range 12 to 53), 80% of patients were disease free. The remaining 20% passed away demonstrating a median survival of 25 months (range 13-38). Eighty-eight percent of patients were satisfied with their decision to undergo the operation, 91.4% would undergo it once more if needed and 91.4% would advise it to a patient their age. Conclusions: Radical nephrectomy and nephroureterectomy are safe and effective in well-selected patients over 80 years old. Elderly patients exhibit comparable preoperative outcomes and survival benefits to those achieved in younger patients. Various preoperative clinical variables that effect the survival of patients but not their recovery could be identified.

Outcomes of minimally invasive nephroureterectomy in octogenarians: a single centre experience and review of literature

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Calcaneal acrometastasis from urothelial carcinoma of the ureter: a case report and literature review

“…The standard treatment for ureteral urothelial cancer consists of nephroureterectomy, with removal of the bladder cuff 4. In 2010, Labanaris et al16 demonstrated the efficacy and safety of nephroureterectomy in elderly patients over the age of 80. Chemotherapy treatment for ureteral urothelial tumors involves similar treatment to that of urothelial carcinoma of the bladder, due to the similar histology of these two diseases 4.…”