Influencing factors and prognosis of postoperative complications in elderly(≥75 years)patients with renal cell carcinoma after laparoscopic surgery
10.12483/j.issn.1009-8291.2026.06.002
- VernacularTitle:老年（≥75岁）肾癌患者腹腔镜手术术后并发症的影响因素及预后分析
- Author:
Zhiying WU
1
;
Min QIU
1
;
Dameng PAN
1
;
Xiaojun TIAN
1
;
Lei ZHAO
1
;
Hongxian ZHANG
1
;
Shudong ZHANG
1
;
Lulin MA
1
Author Information
1. Department of Urology, Peking University Third Hospital, Beijing 100191, China
- Publication Type:Journal Article
- Keywords:
renal cell carcinoma;
elderly patients;
laparoscopic surgery;
prognosis
- From:
Journal of Modern Urology
2026;31(6):503-509
- CountryChina
- Language:Chinese
-
Abstract:
Objective To analyze the postoperative complications and survival outcomes of elderly patients with renal cell carcinoma undergoing laparoscopic surgery, and to identify the influencing factors, so as to provide reference for improving the safety of laparoscopic surgery in such patients. Methods A retrospective analysis was conducted on the clinical, surgical, and pathological data of 153 patients aged ≥75 years who underwent laparoscopic nephrectomy for renal cell carcinoma at our hospital during 2012 and 2025.Logistic regression analyses were performed to identify factors influencing postoperative complications, and a nomogram was constructed and validated to predict the complications.Kaplan-Meier method was used to draw the survival curve, and the effects of different surgical approaches on the prognosis and the survival difference in the age subgroups (75-＜80 years, ≥80 years) were analyzed.Cox regression analyses were conducted to determine factors affecting survival outcomes. Results Among the 153 patients, 15 developed postoperative complications, including 5 severe cases. Multivariate logistic regression identified Charlson Comorbidity Index (CCI) ≥3 and prolonged operation time as independent risk factors for postoperative complications (P＜0.05).The C-index of the logistic regression model constructed based on these factors (age, CCI≥3 and operation time) was 0.77 (95%CI:0.64-0.90), with an average absolute error of 1.6%.Subgroup analysis revealed superior overall survival in patients aged 75-＜80 years undergoing partial nephrectomy compared to radical nephrectomy (P=0.005 6).No statistically significant difference in overall survival was observed among patients ≥80 years who received different surgical approaches (P=0.062).Multivariate Cox regression analysis identified preoperative low albumin levels, preoperative renal insufficiency, tumor diameter＞4 cm, and pathological stage as independent risk factors for overall survival (P＜0.05). Conclusion Laparoscopic surgery is safe and effective for elderly patients with renal cell carcinoma, with survival outcomes correlated to nutritional status, renal function, tumor size and pathological staging.Patients aged ≥80 years still derive surgical benefit, and no survival differences exist between different surgical approaches in this age group.
