Survival benefit stratification of partial nephrectomy versus non‐surgical treatment in elderly patients with T1a renal cell carcinoma

BACKGROUND: Renal cell carcinoma (RCC) of stage T1a has been proven to be of low‐grade malignancy and mostly affects elderly individuals with relatively limited life expectancy. However, research on the survival benefit of surgery relative to non‐surgical treatment (NST) is limited. The aim of the study was to investigate the survival difference between partial nephrectomy (PN) and NST and to establish a benefit stratification model for elderly patients (≥70 years) diagnosed with T1a RCC. PATIENTS AND METHODS: Patients diagnosed with non‐metastatic T1a RCC who received PN or NST were identified from the SEER database during 2004–2015. Before survival analysis, propensity score matching (PSM) was performed. Overall survival (OS) was estimated by the Kaplan–Meier method, and subgroup analyses were used to identify favorable factors of PN. Independent factors of survival were recognized by multivariate Cox regression analysis. RESULTS: Patients diagnosed with non‐metastatic T1a RCC who received PN or NST were identified from the SEER database during 2004–2015. Before survival analysis, propensity score matching (PSM) was performed. Overall survival (OS) was estimated by the Kaplan–Meier method, and subgroup analyses were used to identify favorable factors of PN. Independent factors of survival were recognized by multivariate Cox regression analysis. CONCLUSIONS: Our findings suggest that the survival benefit of PN could be stratified based on the clinical characteristics in patients with stage T1a RCC aged 70 years or older, which may help physicians and patients optimize clinical decisions.