The influence of age on treatment choice and survival in 735 patients with renal carcinoma

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Abstract
To determine whether age is related to treatment choice and survival in patients with renal carcinoma. In this retrospective study 735 patients with renal carcinoma, diagnosed between 1982 and 1990 in one of the hospitals connected to the Rotterdam Cancer Registry, were evaluated with respect to treatment choice and survival. Nephrectomy was performed less often in elderly patients, both with and without distant metastases. The resection rate for patients aged 70 years and older was 63% against 82% for younger patients (P < 0.001). Crude 5-year survival rates for patients aged 20-59, 60-69 and 70+ were 54, 38 and 22% respectively. For patients with tumours restricted to the kidney (Robson stage 1), corrected survival rates were 80, 70 and 48% respectively. The overall post-operative mortality was 3.8% and was not related to age (P = 0.73). Treatment choice and outcome in patients with renal carcinoma were affected by age. As the proportion of patients aged 70 years and older, now 38%, will inevitably increase in the next decades, more attention is needed with respect to contra-indications for surgical treatment in the elderly.