Frailty predicts outcome of partial nephrectomy and guides treatment decision towards active surveillance and tumor ablation

Purpose To examine frailty and comorbidity as predictors of outcome of nephron sparing surgery (NSS) and as decision tools for identifying candidates for active surveillance (AS) or tumor ablation (TA). Methods Frailty and comorbidity were assessed using the modified frailty index of the Canadian St...

Full description

Saved in:
Bibliographic Details
Published in:World journal of urology 2021-08, Vol.39 (8), p.2843-2851
Main Authors: Walach, M. T., Wunderle, M. F., Haertel, N., Mühlbauer, J. K., Kowalewski, K. F., Wagener, N., Rathmann, N., Kriegmair, M. C.
Format: Article
Language:English
Subjects:
Ablation
Ablation Techniques - adverse effects
Ablation Techniques - methods
Aged
Aging
Albumin
Canada - epidemiology
Clinical Decision-Making
Comorbidity
Decision making
Female
Frailty
Frailty - blood
Frailty - diagnosis
Frailty - epidemiology
Geriatric Assessment - methods
Humans
Hypoalbuminemia - diagnosis
Hypoalbuminemia - etiology
Kidney cancer
Kidney Neoplasms - epidemiology
Kidney Neoplasms - pathology
Kidney Neoplasms - therapy
Kidneys
Male
Medicine
Medicine & Public Health
Nephrectomy
Nephrectomy - adverse effects
Nephrectomy - methods
Nephrology
Oncology
Organ Sparing Treatments - methods
Outcome Assessment, Health Care
Patient Selection
Patients
Postoperative Complications - diagnosis
Postoperative Complications - etiology
Predictive Value of Tests
Prognosis
Sarcopenia - diagnosis
Sarcopenia - etiology
Skeletal muscle
Surgical outcomes
Surveillance
Topic Paper
Urology
Watchful Waiting - methods
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Purpose To examine frailty and comorbidity as predictors of outcome of nephron sparing surgery (NSS) and as decision tools for identifying candidates for active surveillance (AS) or tumor ablation (TA). Methods Frailty and comorbidity were assessed using the modified frailty index of the Canadian Study of Health and Aging (11-CSHA) and the age-adjusted Charlson-Comorbidity Index (aaCCI) as well as albumin and the radiological skeletal-muscle-index (SMI) in a cohort of n  = 447 patients with localized renal masses. Renal tumor anatomy was classified according to the RENAL nephrometry system. Regression analyses were performed to assess predictors of surgical outcome of patients undergoing NSS as well as to identify possible influencing factors of patients undergoing alternative therapies (AS/TA). Results Overall 409 patient underwent NSS while 38 received AS or TA. Patients undergoing TA/AS were more likely to be frail or comorbid compared to patients undergoing NSS (aaCCI: p  
ISSN:0724-4983
1433-8726
DOI:10.1007/s00345-020-03556-7