Reassessing age limits: Outcomes of radical nephroureterectomy in octogenarian patients with upper tract urothelial carcinoma.

IF 2.1 3区医学 Q2 UROLOGY & NEPHROLOGY

Investigative and Clinical Urology Pub Date : 2026-03-01 DOI:10.4111/icu.20250274

Sang Hun Song, Haesung Lee, Younsoo Chung, Byeongdo Song, Hakmin Lee, Jong Jin Oh, Sangchul Lee, Seok-Soo Byun, Sung Kyu Hong

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Abstract

Purpose: To assess whether radical nephroureterectomy (RNU) confers oncologic and perioperative benefit in patients aged 80 years or older with upper tract urothelial carcinoma (UTUC).

Materials and methods: This retrospective cohort study included 710 patients who underwent RNU at a tertiary center from 2003 to 2022. Patients were stratified into octogenarian (OG) (≥80 years, n=96) and non-octogenarian (NOG) (<80 years, n=614) groups. Demographics, perioperative variables, and oncologic outcomes were compared. Multivariate Cox regression was performed for overall survival and cancer-specific survival (CSS).

Results: OG had a higher rate of hypertension (72.9% vs. 50.2%) and lower body mass index (23.6 kg/m² vs. 24.5 kg/m², p=0.028), with similar pathologic stage and tumor grade compared to NOG. OG were more likely to undergo minimally invasive surgery (84.3% vs. 75.3%, p<0.001). Overall complication rate was higher in OG (68.8% vs. 55.2%, p=0.013), but major complications were not (5.2% vs. 3.3%, p=0.340). At median follow-up of 43.6 months, no difference in CSS was found. Positive surgical margin was the only independent predictor of CSS.

Conclusions: RNU can be safely and effectively performed in well-selected OG with UTUC. Age ≥80 years was not associated with inferior CSS outcomes or increased major morbidity.

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重新评估年龄限制：八十多岁上尿路上皮癌患者行根治性肾输尿管切除术的结果。

目的：评估根治性肾输尿管切除术（RNU）对80岁及以上上尿路上皮癌（UTUC）患者的肿瘤和围手术期疗效。材料和方法：本回顾性队列研究包括2003年至2022年在三级中心接受RNU的710例患者。患者分为80岁以上高龄（OG）（n=96）和非80岁高龄（NOG）(结果：与NOG相比，OG的高血压发生率更高（72.9% vs. 50.2%），体重指数更低（23.6 kg/m²vs. 24.5 kg/m²，p=0.028），病理分期和肿瘤分级相似。OG患者更有可能接受微创手术（84.3% vs. 75.3%）。结论：在精心选择的OG患者中，采用UTUC可以安全有效地进行RNU手术。年龄≥80岁与不良的CSS结果或增加的主要发病率无关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Investigative and Clinical Urology Medicine-Urology

CiteScore

4.10

自引率

4.30%

发文量

审稿时长

4 weeks

期刊介绍： Investigative and Clinical Urology (Investig Clin Urol, ICUrology) is an international, peer-reviewed, platinum open access journal published bimonthly. ICUrology aims to provide outstanding scientific and clinical research articles, that will advance knowledge and understanding of urological diseases and current therapeutic treatments. ICUrology publishes Original Articles, Rapid Communications, Review Articles, Special Articles, Innovations in Urology, Editorials, and Letters to the Editor, with a focus on the following areas of expertise: • Precision Medicine in Urology • Urological Oncology • Robotics/Laparoscopy • Endourology/Urolithiasis • Lower Urinary Tract Dysfunction • Female Urology • Sexual Dysfunction/Infertility • Infection/Inflammation • Reconstruction/Transplantation • Geriatric Urology • Pediatric Urology • Basic/Translational Research One of the notable features of ICUrology is the application of multimedia platforms facilitating easy-to-access online video clips of newly developed surgical techniques from the journal''s website, by a QR (quick response) code located in the article, or via YouTube. ICUrology provides current and highly relevant knowledge to a broad audience at the cutting edge of urological research and clinical practice.