Contemporary Patients Have Better Perioperative Outcomes Following Cytoreductive Nephrectomy : A Multi-institutional Analysis of 1272 Consecutive Patients
Copyright © 2023. Published by Elsevier Inc..
OBJECTIVE: To evaluate factors associated with perioperative outcomes in a multi-institutional cohort of patients treated with cytoreductive nephrectomy (CN).
METHODS: Data were analyzed for metastatic renal cell carcinoma patients treated with CN at 6 tertiary academic centers from 2005 to 2019. Outcomes included: Clavien-Dindo complications, mortality, length of hospitalization, 30-day readmission rate, and time to systemic therapy. Univariate and multivariable models evaluated associations between outcomes and prognostic variables including the year of surgery.
RESULTS: A total of 1272 consecutive patients were treated with CN. Patients treated in 2015-2019 vs 2005-2009 had better performance status (P<.001), higher pathologic N stage (P = .04), more frequent lymph node dissections (P<.001), and less frequent presurgical therapy (P = .02). Patients treated in 2015-2019 vs 2005-2009 had lower overall and major complications from surgery, 22% vs 39%, P<.001% and 10% vs 16%, P = .03. Mortality at 90days was higher for patients treated 2005-2009 vs 2015-2019; 10% vs 5%, P = .02. After multivariable analysis, surgical time period was an independent predictor of major complications and 90-day mortality following cytoreductive surgery.
CONCLUSION: Postoperative major complications and mortality rates following CN are significantly lower in patients treated within the most recent time period.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:182 |
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| Enthalten in: |
Urology - 182(2023) vom: 08. Dez., Seite 168-174 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Esdaille, Ashanda R [VerfasserIn] |
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| Anmerkungen: |
Date Completed 11.12.2023 Date Revised 23.04.2024 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1016/j.urology.2023.08.024 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| 500 | |a Date Revised 23.04.2024 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2023. Published by Elsevier Inc. | ||
| 520 | |a OBJECTIVE: To evaluate factors associated with perioperative outcomes in a multi-institutional cohort of patients treated with cytoreductive nephrectomy (CN) | ||
| 520 | |a METHODS: Data were analyzed for metastatic renal cell carcinoma patients treated with CN at 6 tertiary academic centers from 2005 to 2019. Outcomes included: Clavien-Dindo complications, mortality, length of hospitalization, 30-day readmission rate, and time to systemic therapy. Univariate and multivariable models evaluated associations between outcomes and prognostic variables including the year of surgery | ||
| 520 | |a RESULTS: A total of 1272 consecutive patients were treated with CN. Patients treated in 2015-2019 vs 2005-2009 had better performance status (P<.001), higher pathologic N stage (P = .04), more frequent lymph node dissections (P<.001), and less frequent presurgical therapy (P = .02). Patients treated in 2015-2019 vs 2005-2009 had lower overall and major complications from surgery, 22% vs 39%, P<.001% and 10% vs 16%, P = .03. Mortality at 90days was higher for patients treated 2005-2009 vs 2015-2019; 10% vs 5%, P = .02. After multivariable analysis, surgical time period was an independent predictor of major complications and 90-day mortality following cytoreductive surgery | ||
| 520 | |a CONCLUSION: Postoperative major complications and mortality rates following CN are significantly lower in patients treated within the most recent time period | ||
| 650 | 4 | |a Multicenter Study | |
| 650 | 4 | |a Journal Article | |
| 700 | 1 | |a Karam, Jose A |e verfasserin |4 aut | |
| 700 | 1 | |a Master, Viraj A |e verfasserin |4 aut | |
| 700 | 1 | |a Spiess, Philippe E |e verfasserin |4 aut | |
| 700 | 1 | |a Raman, Jay D |e verfasserin |4 aut | |
| 700 | 1 | |a Sharma, Pranav |e verfasserin |4 aut | |
| 700 | 1 | |a Shapiro, Daniel D |e verfasserin |4 aut | |
| 700 | 1 | |a Das, Arighno |e verfasserin |4 aut | |
| 700 | 1 | |a Sexton, Wade J |e verfasserin |4 aut | |
| 700 | 1 | |a Zemp, Logan |e verfasserin |4 aut | |
| 700 | 1 | |a Patil, Dattatraya |e verfasserin |4 aut | |
| 700 | 1 | |a Allen, Glenn O |e verfasserin |4 aut | |
| 700 | 1 | |a Matin, Surena F |e verfasserin |4 aut | |
| 700 | 1 | |a Wood, Christopher G |e verfasserin |4 aut | |
| 700 | 1 | |a Abel, Edwin Jason |e verfasserin |4 aut | |
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