Differences in Unmet Needs Between Older and Younger Patients With Advanced Renal Cell Carcinoma

The therapeutic landscape for advanced renal cell carcinoma (aRCC) has improved significantly, leading to extended treatment durations. Because many patients receiving systemic therapy are older adults, optimizing treatment and supportive care across age groups is critical. This study aimed to clarify age-related differences in unmet needs and specific concerns among patients with aRCC.

We retrospectively reviewed 83 patients who initiated first-line systemic therapy for aRCC. Patients were divided into an older group (>70 years; n=39) and a younger group (≤70 years; n=44). Data regarding symptoms, concerns, physical and psychological distress, and treatment preferences at treatment initiation were extracted from interview sheets and compared between the groups.

No significant differences were observed between the age groups regarding the severity of physical or psychological distress, or the prevalence of physical symptoms. However, younger patients reported significantly greater concerns regarding "work" (p<0.01) and tended to have more "financial issues" (p=0.054) than older patients. Half of the younger patients (50%) were willing to pursue further treatment with severe side effects if standard therapy became difficult, compared to 36% of older patients (p=0.461).

Older age was not associated with increased distress or a decreased willingness to pursue treatment. Because socioeconomic challenges represent a significant unmet need for younger patients, supportive care strategies should be carefully tailored to address these specific concerns.