ASCO: Surveillance Viable for Small Renal Masses in Elderly
(HealthDay News) – For elderly patients with small renal masses, surveillance does not adversely affect kidney cancer-specific survival, and is associated with lower all-cause mortality and risk of cardiovascular events, according to a study presented at the American Society of Clinical Oncology's annual Genitourinary Cancers Symposium, held from Feb. 14–16 in Orlando, FL.
William C. Huang, MD, from the New York University Medical Center in New York City, and colleagues analyzed data from the surveillance, epidemiology, and end results cancer registry linked with Medicare claims for 8,317 patients aged ≥66 years who were diagnosed with small renal masses (<4cm) between 2000 and 2007.
The researchers found that 70% of patients underwent surgery and 31% underwent surveillance. From 2000–2007 there was a significant increase in the use of surveillance, from 25% to 37%. After controlling for patient and disease characteristics, surveillance was associated with a significantly lower risk of death from any cause (hazard ratio, 0.84) and of suffering a cardiovascular event (hazard ratio, 0.79) during a median follow-up of 58 months. There was no significant difference in kidney cancer-specific survival based on treatment approach.
"Our analysis indicates that physicians can comfortably tell an elderly patient, especially a patient that is not healthy enough to tolerate general anesthesia and surgery, that the likelihood of dying of kidney cancer is low and that kidney surgery is unlikely to extend their lives," Huang said in a statement.