Renal cancer surgery in the elderly

Renal cell carcinoma mainly develops in the sixth or seventh decade of life. As life expectancy increases, urologists have to deal with elderly patients presenting with renal cancer. The introduction of ablative techniques has even widened our armamentarium of treating elderly patients with renal cancer apart from the standard laparoscopic and open surgical procedures. Our review highlights the current literature focusing on the functional and oncological outcome of surgically treated renal cancer in elderly patients.

Despite the higher percentage of comorbidities, perioperative morbidity and declined renal reserve in elderly patients, radical or partial nephrectomy being performed open or laparoscopically for localized disease offers excellent functional and oncological outcome in this age group. Elderly patients seem to benefit more from laparoscopic procedures with lower rates of perioperative morbidity and faster convalescence compared with the open approach. Ablative techniques performed percutanousely may be promising for small renal masses in the future.

Surgical treatment of renal cancer performed laparoscopically or open is feasible and well tolerated in elderly patients, with low perioperative morbidity and a good overall survival rate. Long-term results for ablative techniques are still missing for this age group. Patients should be carefully selected for one of the surgical treatments according to their health, fitness, wishes and the experience of the referred centre.