Postoperative outcomes of elderly patients undergoing partial nephrectomy

Area of Science:

• Urology
• Surgical Oncology
• Geriatric Medicine

Background:

• Partial nephrectomy (PN) is increasingly performed in elderly patients.
• Assessing clinical outcomes and predictors of complications in this population is crucial.

Purpose of the Study:

• To describe clinical outcomes of patients aged 75 years and above after PN.
• To identify independent factors associated with postoperative complications.

Main Methods:

• Retrospective review of a multi-institutional database of 191 patients (≥75 years) undergoing PN (2003-2016).
• Data included peri-operative details, follow-up, and complication rates (Clavien III-V).
• Multivariate logistic regression analyzed predictive factors for complications, adjusting for age and RENAL score.

Main Results:

• The severe complication rate was 6.2%.
• Robotic-assisted surgery was an independent protective factor against medical postoperative complications (OR=0.31) and overall complications (OR=0.22).
• Tumor size was associated with increased complication risk (OR=1.13), while patient age did not predict complications.

Conclusions:

• Partial nephrectomy can be safely performed in elderly patients with acceptable morbidity.
• Robotic assistance is a significant independent protective factor for postoperative complications in this age group.
• PN should be considered a viable treatment option for older adults with renal masses.