Older age is significantly associated with greater kidney function decline after radical nephrectomy in patients with kidney cancer, investigators reported at American Society of Clinical Oncology’s 2023 Genitourinary Cancers Symposium in San Francisco, California.
The finding is from a retrospective study of 2436 patients who underwent radical nephrectomy from the International Marker Consortium for Renal Cancer (INMARC). Of the cohort, 513 patients were aged less than 50 years, 1344 were aged 50-70 years, and 579 were older than 70 years. Patients had a median follow-up of 31.9 months.
On multivariable analysis, increasing age was significantly associated with a 3.4- to 9.4-fold increased risk of developing de novo stage 3a chronic kidney disease (CKD), a 3.4- to 7.7-fold increased risk of stage 3b CKD, and a 2.0-fold risk of stage 4 CKD after surgery, Mimi Nguyen, a medical student at University of California San Diego, reported on behalf of her team.
As age category increased, the proportion of patients with 5-year freedom from de novo CKD after radical nephrectomy decreased. Post-surgery CKD stage 3a developed in 73.9% vs 53.7% vs 37.1% of patients aged less than 50, 50-70, and more than 70 years, respectively. De novo CKD stage 3b developed in 92.7% vs 71.8% vs 55.5%, respectively. De novo CKD stage 4 occurred in 93.7% vs 89.8% vs 81.2%, respectively.
On linear-regression analysis, increasing age was significantly correlated with greater decline in estimated glomerular filtration rate (eGFR; β=-0.212) after radical nephrectomy.
“Increasing age is a risk factor for progressive and clinically significant renal functional decline after [radical nephrectomy], Nguyen and colleagues concluded in a study abstract.” Prioritization for nephron-sparing management may be considered when indicated and oncologically safe and feasible in elderly patients to reduce potential risk of sequelae of functional decline.”
Nguyen M, Walia A, Saidian A, et al. Impact of age on functional decline following radical nephrectomy: Analysis of the International Marker Consortium for Renal Cancer (INMARC). ASCO GU 2023, San Francisco, California, February 16-18. Abstract 664.