Journal of Reconstructive Urology

.: ORIGINAL RESEARCH
Survival Outcomes in Elderly Patients with Renal Cell Carcinoma: A Single-Center Experience
Renal Hücreli Karsinomlu Yaşlı Hastalarda Sağkalım Sonuçları: Tek Merkez Deneyimi
Sait ÖZBİRa, Halil Lütfi CANATa, Hasan Anıl ATALAYa, İlter ALKANa, Erdal ABAYa, Alper ÖTÜNÇTEMURa, Fatih ALTUNRENDEa
aClinic of Urology, Okmeydanı Training and Research Hospital, İstanbul, TURKEY
J Reconstr Urol. 2019;9(2):51-6
doi: 10.5336/urology.2019-70949
Article Language: EN
Full Text
ABSTRACT
 Objective: The aim of the study was to investigate the survival outcomes in elderly patients with renal cell carcinoma (RCC) in our series. Materials and Methods: From January 2010 to June 2019, 174 patients with renal cell carcinoma who underwent surgery in our institution were analyzed. Age, gender, history, presentation, tumor size,tumor, node, metastasis (TNM) stage, histologic subtype and Fuhrman grade of the patients were recorded. Patients were divided into two groups with the cut off value 70 of age. Group 1 was defined as the patients below the 70 years of age, whereas, Group 2 was defined as the patients 70 years of age and older. Results: One hundred three patients were in Group 1 and 71 patients were in Group 2. Mean disease-specific survival(DSS) time was 140.3±6.7 months in Group 1, while it was 105.3±7.9 months in Group 2 (p=0.061). Mean overall survival time (OAS) was 132.0±7.5 months in Group 1 and 95.2±8.3 months in Group 2 (p=0.046). Actuarial estimated disease-specific survival at 5 years was 88.5% in Group 1and 78.1 % in Group 2 (p=0.061). Actuarial estimated overall survival at 5 years was 83.0% in Group 1 and 70.7 % in Group 2 (p=0.046). In multivariate Cox regression analysis, T stage and Fuhrman grade were independent prognostic factors for survival. Conclusion: Our study demonstrated that there was no statistically significant difference in disease-specific survival rates between elderly patients with RCC, those compared with younger ones. Our findings recommend that surgery may be an option for older patients with RCC to avoid the potential hazard.

Keywords: Age factor; elderly; kidney; renal cell carcinoma; survival
ÖZET
 Amaç: Çalışmanın amacı, serimizdeki renal hücreli karsinomlu (RHK) yaşlı hastalarda sağkalım sonuçlarını araştırmaktı. Gereç ve Yöntemler: Ocak 2010-Haziran 2019 tarihleri arasında kurumumuzda cerrahi uygulanan 174 renal hücre karsinomlu hasta analiz edildi. Hastaların yaş, cinsiyet, öykü, prezentasyon, tümör büyüklüğü, tümör, nodül, metastaz (TNM) evresi, histolojik alt tip ve Fuhrman derecesi kaydedildi. Hastalar eşik değeri 70 yaş olan iki gruba ayrıldı. Grup 1, 70 yaşın altındaki hastalar olarak tanımlanırken, Grup 2, 70 yaş ve üstü hastalar olarak tanımlandı. Bulgular: Yüz üç hasta Grup 1'de ve 71 hasta Grup 2'de idi. Grup 1'in ortalama yaşı 56,9±10,2 ve Grup 2'nin ise 77,0±5,2 idi (p <0,001). Gruplar arasında cinsiyet dağılımı açısından istatistiksel olarak anlamlı fark yoktu (p=0,643). Ortalama hastalığa özgü sağkalım (HÖS) süresi Grup 1'de 140,3±6,7 ay iken Grup 2'de 105,3±7,9 ay idi (p=0,061). Ortalama genel sağkalım (GS) süresi Grup 1'de 132,0±7,5 ay ve Grup 2'de 95,2±8,3 ay idi (p=0,046). Beş yıllık hastalığa özgü sağkalım oranı Grup 1'de %88,5, Grup 2'de% 78.1 idi (p=0.061). 5 yıllık genel sağkalım oranı, Grup 1'de %83'0, Grup 2'de %70,7 idi (p=0,046). Çok değişkenli Cox regresyon analizinde, T evresi ve Fuhrman derecesi sağkalım için bağımsız prognostik faktörlerdi. Sonuç: Çalışmamız, RHK'lu yaşlı hastalar arasında, genç olanlarla karşılaştırıldığında, hastalığa özgü sağkalım oranları açısından istatistiksel olarak anlamlı bir fark olmadığını göstermiştir. Bulgularımız, ameliyatın potansiyel tehlikeyi önlemek için RHK'lu yaşlı hastalar için bir seçenek olabileceğini önermektedir.

Anahtar Kelimeler: Yaş faktörleri; yaşlı; böbrek; renal hücreli kanser; sağkalım
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