Radical or Partial Nephrectomy for Localized Disease in Elderly Patients? Partial Nephrectomy

摘要

The increase in the incidental detection of small renal masses over the last 20 years has produced a population of patients for whom clinical decisions are uninformed by randomized controlled trial evidence: elderly patients. The aging of the U.S. population, combined with the rising incidence of small renal masses found on evaluation of alternative complaints, rather than clinical symptoms related to the mass, means that the management of these tumors among elderly patients will become a more prominent concern. Given that the prevalence of comorbid conditions parallels aging, the competing risk of these other health problems may be the most important determinant of the best course of action for elderly patients newly diagnosed with a suspicious small renal mass. For elderly patients deemed to be candidates for surgery based on a shared decision-making process with their urologist, partial nephrectomy is an excellent treatment option and the standard of care for elderly and nonelderly patients with anatomically appropriate, small kidney tumors.