Age and ECOG Performance Status as Predictors of Survival of Patients with Upper Urinary Tract Urothelial Carcinoma Undergoing Radical Nephroureterectomy

Eismann, Lennert; Bohn, Lucas; Buchner, Alexander; Casuscelli, Jozefina; Volz, Yannic; Weinhold, Philipp; Wuelfing, Christian; Waidelich, Raphaela; Stief, Christian G.; Schlenker, Boris und Rodler, Severin (2022): Age and ECOG Performance Status as Predictors of Survival of Patients with Upper Urinary Tract Urothelial Carcinoma Undergoing Radical Nephroureterectomy. In: Urologia Internationalis, Bd. 107, Nr. 1: S. 72-79

Abstract

Introduction: This study aimed to evaluate the impact of chronological and biological age on perioperative complications and survival after radical nephroureterectomy (RNU). Elderly patients with upper-tract urothelial carcinoma might be overtreated by RNU. Methods: We retrospectively analyzed patients undergoing RNU. To evaluate the perioperative risk, patients were divided into four groups (<75;75-79;80-84;>= 85 years). The endpoints are perioperative complications and survival (overall survival [OS]). We calculated a risk score including chronological and biological age (Eastern cooperative oncology group performance status). Statistical analysis was performed by Kruskal-Wallis, Mann-Whitney U, chi(2), log-rank, and Breslow tests. Results: 194 patients were included in the study. Median follow-up was 25.5 months. Elderly cohorts >= 2 presented a higher number of days in intensive care unit following RNU (p < 0.001). Complication rates increased from cohort 1-4 with rates of 48.8%;55.2%;92.0%;85.7% (p < 0.001). Median survival was 115, 55, 28, and 20 months for cohorts 1, 2, 3, and 4, respectively. The combined risk score revealed a significant 5-year OS benefit for patients with score 0 (82.3%) compared to score 1 (46.0%) and score 2 (15.0%;p < 0.001). Discussion/Conclusion: We evaluated the impact of chronological and biological age on perioperative complications and survival after RNU. A combined risk score of chronological and biological age correlates with survival after RNU.

• Dokumententyp: Zeitschriftenartikel
• Fakultät: Medizin
• Themengebiete: 600 Technik, Medizin, angewandte Wissenschaften > 610 Medizin und Gesundheit
• ISSN: 0042-1138
• Sprache: Englisch