Key result
Surgical outcomes and overall survival for older patients (≥70 years) with RCC-IVC were not inferior to younger patients (median OS 66.6 months vs not reached; P=0.695).
Why the study?
It was unclear how surgical and oncological outcomes for older patients undergoing surgery for renal cell carcinoma with inferior vena cava tumor compare with those of younger patients.
Does surgery for RCC-IVC in older patients (≥70 years) yield comparable outcomes to younger patients (<70 years)?
Cohort (n=123)
Yes
Does surgery for RCC-IVC in older patients (≥70 years) yield comparable outcomes to younger patients (<70 years)?
p-value: p=0.695
Surgical outcomes for older patients (≥70 years) with RCC and IVC thrombus are not inferior to those of younger patients, suggesting surgery remains a viable option with careful patient selection.
OBJECTIVES: To compare the surgical and oncological outcomes of older patients undergoing surgery for renal cell carcinoma (RCC) with a tumor in the inferior vena cava (IVC) and those of younger patients. MATERIALS AND METHODS: We retrospectively evaluated 123 patients who underwent surgery for RCC-IVC at two institutions between 2008 and 2019. We classified them into the ≥70 years and the <70 years group, based on their age during surgery. The patients' perioperative outcomes as well as survival (overall survival [OS] and cancer-specific survival [CSS]) were evaluated and compared before and after 1:1 propensity score matching. Sensitivity analyses were performed at age thresholds of 75 and 80 years. RESULTS: The ≥70 and the <70 groups comprised 43 and 80 patients, respectively. Most patients in the ≥70 group demonstrated an American Society of Anesthesiologists score of 2 or 3. They were more likely to have a statistically insignificant high (≥3) Charlson Comorbidity index score (16.3 vs. 6.3%) and a lower hemoglobin level (10.4 vs. 11.7 g/dL) than the <70 group. Eighteen (41.9%) and 32 (40.0%) patients had at least one distant metastasis at the time of surgery in the ≥70 and <70 group, respectively. The complication rates (any grade and grade ≥3), the length of hospitalization, readmission rates, and mortality were comparable between the groups, both before and after matching (all, non-specific). There was no statistically significant difference in the OS (median 66.6 vs. not reached [N.R.], P = 0.695) or CSS (N.R. vs. N.R., P = 0.605) between the groups before matching. The OS and CSS results were similar and comparable following matching (both, non-specific). Further, OS and CSS were comparable between the ≥75 and <75 groups, and between the ≥80 and <80 age groups, respectively. CONCLUSION: The surgical outcomes of older patients with RCC-IVC were not inferior to those of younger patients. With careful patient selection, surgery can still be a treatment option.
No takes yet. Share an insight, caveat, or question.
Ishiyama et al. (2022) conducted a cohort in Renal cell carcinoma with inferior vena cava thrombus (n=123). Age ≥70 years vs. Age <70 years was evaluated on Overall survival (p=0.695). Surgical outcomes and overall survival for older patients (≥70 years) with RCC-IVC were not inferior to younger patients (median OS 66.6 months vs not reached; P=0.695).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: