The efficacy of laparoscopic radical nephrectomy for renal cell cancer in the elderly: An oncological outcome analysis

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Abstract
The efficacy and outcome of a laparoscopic radical nephrectomy (LRN) were retrospectively evaluated in patients aged >or=70 years, and the results were compared with those obtained from patients younger than 70 years undergoing laparoscopic surgery for the same indications. Data were collected for all patients undergoing an LRN for renal cell carcinoma between March 1999 and November 2006. A total of 129 LRN were performed. There were 34 elderly patients (>or=70 years) and 95 adult patients (<70 years). The two groups were compared for comorbidity, previous surgical history, operative time, estimated blood loss, tumor size, complications during and after surgery, time to oral intake/ambulation, hospital stay, overall survival and disease free survival rates. In preoperative comorbid conditions, the number of patients with hypertension/ischemic heart disease in the elderly group was significantly greater than that in the adult group (p = 0.01). The elderly group had a mean operative time (247 min vs. 244 min) and blood loss (120 ml vs. 180 ml) similar to those in the adult group. In addition, the incidence of perioperative complications was not different between the two groups (intra-op: 2.9% vs. 5.3%/ post-op: 8.8% vs. 4.2%). All other variables before, during and after surgery were compatible between the two groups. The efficacy and oncological outcome of laparoscopic surgery in elderly patients was as promising as those in their younger counterparts. Therefore, elderly patients should not be excluded from undergoing an LRN, even though they usually present with more comorbidities.