TY - JOUR
T1 - Optimal management of renal cell carcinoma in octogenarians
T2 - Retrospective analysis using updated Korean Renal Cell Carcinoma (KORCC) database
AU - Kim, Jung Kwon
AU - Jung, Gyoohwan
AU - Kwak, Cheol
AU - Jeong, Chang Wook
AU - Kang, Seok Ho
AU - Hong, Sung Hoo
AU - Kim, Yong June
AU - Chung, Jinsoo
AU - Hwang, Eu Chang
AU - Kwon, Tae Gyun
AU - Byun, Seok Soo
N1 - Publisher Copyright:
Copyright: © 2023 Kim et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
PY - 2023/3
Y1 - 2023/3
N2 - Background There is few of optimal management guideline in elderly patients with renal cell carcinoma (RCC). To compare the survival outcomes of octogenarian RCC group and younger RCC group after surgery using nationwide multi-institutional database. Methods A total of 10,068 patients who underwent surgery for RCC were included in the current retrospective, multi-institutional study. A propensity score matching (PSM) analysis was conducted to control other confounding factors in analyzing survival outcomes of octogenarian and younger group RCCs. Kaplan-Meier curve analysis to calculate the survival estimates for cancer-specific survival (CSS) and overall survival (OS), and multivariate Cox-proportional hazard regression analyses to evaluate the significant variables associated with the survival outcomes were also performed. Results Both groups were well-balanced in all baseline characteristics. In a total cohort, Kaplan-Meier survival analysis showed a significantly decreased 5-year and 8-year CSS and OS in the octogenarian group compared with the younger group. However, in a PSM cohort, no significant differences were evident between the two groups in terms of CSS (5-year, 87.3% vs. 87.0%; 8-year, 82.2% vs. 78.9%, respectively, log-rank test, p = 0.964). In addition, age ≥ 80 years (HR, 1.199; 95% CI, 0.497–2.896, p = 0.686) was not a significant prognostic factor of CSS in a PSM cohort. Conclusions The octogenarian RCC group after surgery had comparable survival outcomes compared with younger group after PSM analysis. For the life expectancy of octogenarian is getting longer, active treatment is considerable in patients with good performance status.
AB - Background There is few of optimal management guideline in elderly patients with renal cell carcinoma (RCC). To compare the survival outcomes of octogenarian RCC group and younger RCC group after surgery using nationwide multi-institutional database. Methods A total of 10,068 patients who underwent surgery for RCC were included in the current retrospective, multi-institutional study. A propensity score matching (PSM) analysis was conducted to control other confounding factors in analyzing survival outcomes of octogenarian and younger group RCCs. Kaplan-Meier curve analysis to calculate the survival estimates for cancer-specific survival (CSS) and overall survival (OS), and multivariate Cox-proportional hazard regression analyses to evaluate the significant variables associated with the survival outcomes were also performed. Results Both groups were well-balanced in all baseline characteristics. In a total cohort, Kaplan-Meier survival analysis showed a significantly decreased 5-year and 8-year CSS and OS in the octogenarian group compared with the younger group. However, in a PSM cohort, no significant differences were evident between the two groups in terms of CSS (5-year, 87.3% vs. 87.0%; 8-year, 82.2% vs. 78.9%, respectively, log-rank test, p = 0.964). In addition, age ≥ 80 years (HR, 1.199; 95% CI, 0.497–2.896, p = 0.686) was not a significant prognostic factor of CSS in a PSM cohort. Conclusions The octogenarian RCC group after surgery had comparable survival outcomes compared with younger group after PSM analysis. For the life expectancy of octogenarian is getting longer, active treatment is considerable in patients with good performance status.
UR - http://www.scopus.com/inward/record.url?scp=85151440563&partnerID=8YFLogxK
U2 - 10.1371/journal.pone.0283483
DO - 10.1371/journal.pone.0283483
M3 - Article
C2 - 36996119
AN - SCOPUS:85151440563
SN - 1932-6203
VL - 18
JO - PLoS ONE
JF - PLoS ONE
IS - 3 March
M1 - e0283483
ER -
