THE INFLUENCE OF AGE ON TREATMENT CHOICE AND SURVIVAL IN 735 PATIENTSWITH RENAL-CARCINOMA

Objective To determine whether age is related to treatment choice and survival in patients with renal carcinoma. Patients and methods In thi s retrospective study 735 patients with renal carcinoma, diagnosed bet ween 1982 and 1990 in one of the hospitals connected to the Rotterdam Cancer Registry, were evaluated with respect to treatment choice and s urvival. Results Nephrectomy was performed less often in elderly patie nts. both with and without distant metastases. The resection rate for patients aged 70 years and older was 63% against 82% for younger patie nts (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 tumour s restricted to the kidney (Robson stage 1), corrected survival rates were 80, 70 and 48% respectively. The overall postoperative mortality was 3.8% and was not related to age (P=0.73). Conclusion Treatment cho ice 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 contraindications for surgical treatment in the elderly.