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[19] The present study used the age of 70 years as a threshold; however, when the age of 65 years was used, the prognostic value of age at surgery was not significant (data not shown). In consideration of the increased morbidity in elderly patients, RCC progression and CVD events might have influenced our significant discrimination of age 70 years. In the surgical intervention of RN for RCC, the loss of a large amount of normal nephron tissue is an important factor that influences patient outcome, especially in long-term follow-up care. In a recent review article, Kates et?al. showed an increased risk of non-cancer mortality https://en.wikipedia.org/wiki/Ketanserin of RCC patients who had undergone RN.[20] A total of 12 patients died because of CVD events in our patient cohort. Several studies have reported that the CVD event mortality rate in patients treated with RN varies from 2.5% to 6%.[21-23] The rate of 8.2% (12/147) observed in the present study was higher than the results of previous studies. It is possible that the discrepancy is a result of a longer follow-up duration in the present study (mean 62.3 months in our study vs means of 36,[21] 43[22] and 41 months[23] in previous studies). It is also possible that the high rate of comorbidities in our patient cohort http://www.selleckchem.com/products/liproxstatin-1.html contributed to the discrepancy. A detailed CCI was described in a patient cohort in a previous study.[23] When comparing the CCI between studies, our patient cohort had more comorbidities than the previous study. Because our institution is the most powerful academic hospital in the prefecture, referral patients with comorbid RCC who were not suitable for treatment in local hospitals tended to gather at our institution. However, few papers showed the actual number of cases of CVD event mortality in CKD patient cohorts, although several papers have shown an increased risk of CVD events and all-cause mortality in CKD patient cohorts. Meisinger et?al. showed that CVD event mortality rates in non-CKD and CKD (eGFR 15�C59) patients were 6.9% (432/6301) and 12.6% (155/1233), respectively.[24] The mean age of the CKD patient cohort (male 62.4 years, female 61.5 http://www.selleckchem.com/products/midostaurin-pkc412.html years) was similar with that of the present study, whereas the age of the non-CKD patient cohort was younger (male 57.2 years, female 56.6 years). The CVD event mortality rate of 8.2% in the present study was higher than that of the non-CKD patient cohort and lower than that of the CKD cohort. The relatively higher CVD event mortality rate in their CKD patient cohort might be a result of the longer follow-up duration of their study (median 12.5 years). Huang et?al. determined that after a median follow-up period of 4 years, patients with tumors