Assessing the Impact of Old Age on Upper Tract Urothelial Carcinoma: A Retrospective Analysis from a Portuguese Tertiary Center
DOI:
https://doi.org/10.24915/aup.250Keywords:
Aged, Carcinoma, Transitional Cell, Nephroureterectomy, Neoplasm Recurrence, Local, Ureteral Neoplasms, Urinary Bladder NeoplasmsAbstract
Introduction: Upper tract urothelial carcinoma is an infrequent but aggressive disease. Radical nephroureterectomy is the standard of care for nonmetastatic tumors. The potential implications of old age in the management of upper tract urothelial carcinoma are still controversial. Our aim was to analyze the effect of old age on peri-operative and oncological outcomes after radical nephroureterectomy.
Methods: We performed an observational and retrospective analysis of patients submitted to radical nephroureterectomy for nonmetastatic upper tract urothelial carcinoma in our centre between January 2018 and June 2023. Seventy-nine patients were included and divided according to their age at the time of surgery (<80 or ≥80 years old). Perioperative variables and oncological outcomes were compared between the groups. Kaplan–Meier analysis and univariable Cox regression models were used to evaluate disease-free survival, metastasis-free survival and overall survival distribution between the groups.
Results: Sixteen patients (20.5%) were aged 80 or older. We found an association between older age and a higher proportion of invasive disease (pT2 or higher; p=0.048). We also observed that omission of bladder cuff excision was more common in older patients (p=0.008). We found no differences regarding perioperative outcomes. Also, no differences in oncological outcomes, namely, disease-free survival (p=0.884), metastasis-free survival (p=0.867) and overall survival (p=0.916) were found.
Conclusion: Older age at the time of radical nephroureterectomy had no detrimental effect on perioperative and oncological outcomes. Our results suggest that older age by itself should not preclude radical nephroureterectomy.
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