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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 10/2011

01-10-2011 | Urologic Oncology

Mortality and Morbidity After Cytoreductive Nephrectomy for Metastatic Renal Cell Carcinoma: A Population-Based Study

Authors: Firas Abdollah, MD, Maxine Sun, BSc, Rodolphe Thuret, MD, Jan Schmitges, MD, Shahrokh F. Shariat, MD, Paul Perrotte, MD, Francesco Montorsi, MD, Pierre I. Karakiewicz, MD

Published in: Annals of Surgical Oncology | Issue 10/2011

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Abstract

Purpose

To test whether the rates of in-hospital mortality, complications, and transfusions are higher in patients treated with cytoreductive nephrectomy (CNT) for metastatic renal cell carcinoma (mRCC) relative to patients treated with nephrectomy (NT) for non-mRCC.

Methods

We assessed 17,688 patients treated with a NT between years 1999 and 2008, within the Florida Inpatient Database. Chi-square and Student t-tests were used to compare the statistical significance of differences in proportions and means, respectively. Univariable and multivariable logistic regression analyses tested the relationship between surgery type (CNT vs. NT) and three end points: in-hospital mortality, complications, and transfusions.

Results

Overall, 6.0% of patients underwent CNT. The rates of in-hospital mortality, complications, and transfusions were 2.4, 26.5, and 24.3% in CNT patients versus 0.9, 18.9, and 11.1% in NT patients. At multivariable analyses, CNT patients demonstrated a 2.0-, 1.3-, and 2.4-fold higher risk of in-hospital mortality, complications, and transfusions (all P < 0.001). Similarly, more advanced age, comorbidity, and the cumulative number of secondary surgical procedures were independent predictors of a higher risk of in-hospital mortality, complications, and transfusions (all P < 0.001).

Conclusions

The rate of in-hospital mortality, complications, and transfusions is higher in patients treated with CNT relative to NT. Older age, higher comorbidity, and the necessity of secondary surgical procedures further increases the risk of all aforementioned end points. Physicians should consider these observations during the planning of a CNT, and patients should be informed accordingly.
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Metadata
Title
Mortality and Morbidity After Cytoreductive Nephrectomy for Metastatic Renal Cell Carcinoma: A Population-Based Study
Authors
Firas Abdollah, MD
Maxine Sun, BSc
Rodolphe Thuret, MD
Jan Schmitges, MD
Shahrokh F. Shariat, MD
Paul Perrotte, MD
Francesco Montorsi, MD
Pierre I. Karakiewicz, MD
Publication date
01-10-2011
Publisher
Springer-Verlag
Published in
Annals of Surgical Oncology / Issue 10/2011
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-011-1715-2

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