The effect of cytoreductive partial nephrectomy in elderly patients with metastatic renal cell carcinoma：a systematic review

Abstract Background To explore the survival value of cytoreductive partial nephrectomy (cPN) in elderly metastatic renal cell carcinoma (EmRCC).Methods RCC patients aged ≥65 years from 2010 to 2015 in The Surveillance, Epidemiology and End Result database (SEER) were analyzed using Kaplan-Meier (K-M) method and multivariate COX analysis. Propensity score matching (PSM) was performed to balance effects of confounding factors such as general features and pathological features. We were committed to study the long-term survival advantages of cPN patients, explore the appropriate population of cPN, and try to establish a Nomogram model to predict individual survival.Results In EmRCC patients, especially in male patients with tumors size ≦7cm, N0 stage, or isolated metastases, cPN brought a better survival than cytoreductive radical nephrectomy (cRN). Tumor size and N stage were independent risk factors affecting the survival of cPN patients, cPN in patients with tumor size >7cm or N1 stage may present a higher risk of death.Conclusions The implementation of cPN in EmRCC patients who meet specific clinical characteristics like tumors size ≦7cm, N0 stage, or isolated metastases seems to help improve the tumor outcomes.