Robert (82 years old)

Robert, 82 years old, likes to go on morning walks. The doctor recommends it for his osteoarthritis and he enjoys the fresh air. He was diagnosed with bone metastases from ccRCC which occurred 4 years after nephrectomy.

Assessment summary:

• Medical history
  • Hypertension controlled by antihypertensive drugs
  • Aortic stent placement 7 years ago
  • Left radical nephrectomy 4 years ago (ccRCC of 3.1 cm, ISUP grade 2, surgical staging pT1N0)
• ECOG PS: 1 (fatigue and osteoarthritis)
• KPS: 80%
• CT scan: progressive hypervascular lesions of the bone, new lung lesions (biopsy-proven metastases of ccRCC)
• Blood work:
  • Haemoglobin: 11.8 g/dl (12-13 g/dl)
  • Neutrophils: 6.2x10⁹/l (2.0-7.0x10⁹/l)
  • Platelets: 455x10⁹/l (150-400x10⁹/l)
  • Calcium: 10.1 mg/dl (8.5-10.2 mg/dl)
  • LDH: 350 U/l (135-225 U/l)
• Geriatric screening: patient considered candidate for oncologic treatment, with controlled comorbidities and a Geriatric 8 (G8) screening tool score of 15/17*

*healthy patients with a G8 score >14 should receive the same treatment as younger patients according to SIOG guidelines