They acquired their data from the prospectively maintained French National Database on Kidney cancer on > 75-year-old patients that underwent PN between 2003-2016. The data collected was on pre-, peri-, and post-operative outcomes.
Their review included 191 procedures that were either performed via an open approach (n=69), laparoscopic (n=17) and robotic (n=105). The mean tumor size was 4.6 cm, estimated blood loss of 200 mL, severe complications (Clavien III-V) rate was 6.2%, and the median follow up was 25 months with 16 patient deaths and only 3 tumor-related. Their group performed multivariate analysis and found that robotic-assisted PN was an independent protective factor from post-operative complications, however age was not associated with postoperative complications.
They concluded that PN should be considered a viable surgical procedure in the geriatric population group and that robotic-assisted surgery is an independent protective factor from post-operative complications. However, Dr. Sophie advises that careful pre-operative assessment by a geriatrician may help with appropriate patient selection.
Presented by: Duc Sophie, MD
Written by: Egor Parkhomenko, Department of Urology, University of California-Irvine at the 2018 AUA Annual Meeting - May 18 - 21, 2018 – San Francisco, CA USA