Perioperative safety and short-term survival outcomes of radical nephrectomy with thrombectomy in geriatric renal cell carcinoma patients with venous tumor thrombus.

Authors

Yunhe Guan, Peng Hong, Ruotao Xiao, Shiying Tang, Zhuo Liu, Xiaojun Tian, Guoliang Wang, Lulin Ma, Hongxian Zhang, Shudong Zhang

Published in

Minerva urology and nephrology. Volume 78. Issue 3. Pages 352-362.

Abstract

The aim of this study was to evaluate the feasibility and safety of radical nephrectomy with thrombectomy for geriatric renal cell carcinoma (RCC) patients with venous tumor thrombus (VTT).
The retrospective analysis included 542 patients with RCC and VTT between 2014 and 2024. Patients were stratified into geriatric (≥70 years, N.=88) and younger groups (<70 years, N.=454). Propensity score matching (PSM, 1:1) balanced baseline variables, including Mayo classification, TNM stage, surgical approach, and comorbidities. Perioperative outcomes (operative time, blood loss, complications) and 1-year survival rates were compared.
Geriatric patients exhibited higher comorbidity rates (82.95% vs. 64.54%, P=0.001) and ≥3 ASA scores portion (26.14% vs. 14.10%, P=0.004) but shorter tumor diameter (7.9 cm vs. 8.8 cm, P=0.007). After PSM, perioperative outcomes showed no significant difference: operative time (271 vs. 290 min, P=0.14), blood loss (400 vs. 600 mL, P=0.23), complications (37.50% vs. 40.97%, P=0.53) or severe complications (8.0% vs. 9.2%, P=0.67). 1-year overall survival was similar between two groups (94.6% vs. 94.1%, HR=1.04, P=0.90), as was cancer-specific survival (HR=0.98, P=0.96). For the inferior vena cava VTT and M0 stage subgroups, the outcomes were consistent with the above.
This study demonstrates comparable perioperative safety and equivalent short-term survival benefits between geriatric and younger patients undergoing radical nephrectomy with thrombectomy, regardless of VTT complexity and distant metastasis. Age alone should not preclude surgical intervention when supported by comprehensive multidisciplinary assessment.

PMID:
42438981
Bibliographic data and abstract were imported from PubMed on 13 Jul 2026.

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