Complications after radical and partial nephrectomy as a function of age Journal Article

Authors: Lowrance, W. T.; Yee, D. S.; Savage, C.; Cronin, A. M.; O'brien, M. F.; Donat, S. M.; Vickers, A.; Russo, P.
Article Title: Complications after radical and partial nephrectomy as a function of age
Abstract: Purpose: Partial nephrectomy may be underused compared with radical nephrectomy in elderly patients due to concerns about higher complication rates. We determined if the association of age and perioperative outcomes differed between nephrectomy types. Materials and Methods: We identified patients who underwent radical or partial nephrectomy between January 2000 and October 2008. Using multivariable methods we determined whether the relationship between age and risk of postoperative complications, estimated blood loss or operative time differed by nephrectomy type. Results: Of 1,712 patients 651 (38%) underwent radical nephrectomy and 1,061 (62%) underwent partial nephrectomy. Patients treated with partial nephrectomy had higher complication rates than those who underwent radical nephrectomy (20% vs 14%). In a multivariable model age was significantly associated with a small increase in risk of complications (OR for 10-year age increase 1.17, 95% CI 1.04-1.32, p = 0.009). When including an interaction term between age and procedure type, the interaction term was not significant (p = 0.09), indicating there was no evidence the risk of complications associated with partial vs radical nephrectomy increased with advancing age. There was no evidence that age was significantly associated with estimated blood loss or operative time. Conclusions: We found no evidence that elderly patients experience a proportionally higher complication rate, longer operative times or higher estimated blood loss from partial nephrectomy than do younger patients. Given the advantages of renal function preservation we should expand the use of nephron sparing treatment to renal tumors in elderly patients. © 2010 American Urological Association Education and Research, Inc.
Keywords: adult; controlled study; aged; middle aged; surgical technique; retrospective studies; major clinical study; laparoscopic surgery; tumor volume; bleeding; logistic models; age factors; kidney neoplasms; nephrectomy; time factors; postoperative complication; postoperative complications; partial nephrectomy; radical nephrectomy; operation duration; carcinoma; intermethod comparison; urologic surgical procedures; perioperative period; age distribution; race difference; blood loss, surgical; renal cell
Journal Title: Journal of Urology
Volume: 183
Issue: 5
ISSN: 0022-5347
Publisher: Elsevier Science, Inc.  
Date Published: 2010-05-01
Start Page: 1725
End Page: 1730
Language: English
DOI: 10.1016/j.juro.2009.12.101
PUBMED: 20299040
PROVIDER: scopus
PMCID: PMC4179201
Notes: --- - "Export Date: 20 April 2011" - "CODEN: JOURA" - "Source: Scopus"
Altmetric Score
MSK Authors
  1. Caroline Savage
    80 Savage
  2. Paul Russo
    458 Russo
  3. Sherri M Donat
    135 Donat
  4. Andrew J Vickers
    569 Vickers
  5. Matthew Francis O'Brien
    20 O'Brien
  6. Angel M Cronin
    145 Cronin
  7. David Scott Yee
    19 Yee