Clinicopathologic characteristics and prognosis of renal cell carcinoma in patients beyond 70 years: a single center analysis of 11-year data

Objective To investigate the clinicopathologic characteristics and prognosis of renal cell carcinoma (RCC) in patients beyond 70 years. Methods RCC Patients beyond 70 years who underwent surgery at the Affiliated Hospital of Xuzhou Medical University from January 2008 to December 2018 were enrolled and their clinicopathologic data were retrospectively analyzed. The endpoint was all-cause death. The survival curve was drawn by the Kaplan-Meier method, while univariable and multivariable survival analyses were performed by the Cox proportional hazards model. Results A total of 187 patients were enrolled in this study, including 135 men (72.2%) with 121 laparoscopic surgery (64.7%) and 159 radical nephrectomy (85.0%). The percentage of hypertension, diabetes mellitus, anemia and hypoproteinemia was 46.5%, 18.7%, 33.7% and 35.8%, respectively. The most common pathological subtype of RCC was clear RCC (163 cases, 87.2%). The 1-, 3-, 5-year overall survival (OS) rate was 96.2%, 85.7% and 71.1%, respectively. The Cox multivariable analysis showed that AJCC stages (95% CI: 1.450-2.758, P＜0.001) and pathological types (95% CI: 0.189-0.764, P=0.007) were the independent factors influencing the OS of elderly RCC patients. In the T1a stage subgroup, there was no statistical difference in OS between patients undergoing radical nephrectomy and partial nephrectomy; hemoglobin P=0.046) and albumin P=0.004) were the independent prognostic risk factors. Conclusions Elderly RCC patients often have basic diseases. Most patients undergo radical nephrectomy and laparoscopic surgery has become the preferred surgical treatment. AJCC stages and pathological types are the independent factors influencing OS. For T1a stage patients, radical nephrectomy or partial nephrectomy has similar prognosis and hemoglobin and albumin are the independent prognostic risk factors.