Upper urinary tract tumors in elderly patients

Abstract

Upper urinary tract tumor is a rare disease, accounting for 6-7 % of all primary malignant tumors of the kidney, and they occur in association with primary bladder cancer in only 2-4 % of patients. The most common symptoms at presentation are gross painless hematuria, occurring in 70-80 % of patients. In elderly patients, from 10 to 15 % of upper urinary tract tumors are diagnosed as an incidental disease after a computed tomography. The prognosis is well correlated to tumor stage. Compared with younger patients, a corresponding increase in stage and grade in the elderly was found at disease diagnosis. Recent studies report a worse disease-specific survival in older patients who have undergone nephroureterectomy. However, these outcomes reported in advanced age may be linked to a selection bias since patients have significant comorbidities and lower performance status leading to a suboptimal treatment, either surgical or chemotherapic when indicated. Specifically, for elderly patients, treatment should be planned on the basis of an accurate preoperative assessment.