Trifecta outcomes of partial nephrectomy in patients over 75 years old. Analysis of the renal surgery in elderly (RESURGE) group

Partial nephrectomy in elderly patients provides quality outcomes as measured by trifecta. Tumor complexity is a key determinant for trifecta achievement, and trifecta attainment is associated with improved function. Increasing utilization of robotics has benefits in recovery without compromising quality._Partial nephrectomy (PN) in elderly patients is underutilized with concerns regarding risk of complications and potential for poor outcomes. Objective_ To evaluate quality and functional outcomes of PN in patients _75 yr using trifecta as a composite outcome of surgical quality. Design, setting, and participants_ Multicenter retrospective analysis of 653 patients aged _75 yr who underwent PN (REnal SURGery in Elderly [RESURGE] Group). Intervention_ PN. Outcome measurements and statistical analysis_ Primary outcome was achievement of trifecta (negative margin, no major [Clavien ≥3] urological complications, and ≥90% estimated glomerular filtration rate [eGFR] recovery). Secondary outcomes included chronic kidney disease (CKD) stage III and CKD upstaging. Multivariable analysis (MVA) was used to assess variables for achieving trifecta and functional outcomes. Kaplan-Meier survival analysis (KMA) was used to calculate renal functional outcomes. Results and limitations_ We analyzed 653 patients (mean age 78.4 yr, median follow-up 33 mo