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

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 patie...

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Bibliographic Details
Published in:Annals of surgical oncology 2011-10, Vol.18 (10), p.2988-2996
Main Authors: Abdollah, Firas, Sun, Maxine, Thuret, Rodolphe, Schmitges, Jan, Shariat, Shahrokh F., Perrotte, Paul, Montorsi, Francesco, Karakiewicz, Pierre I.
Format: Article
Language:English
Subjects:
Aged
Aged, 80 and over
Carcinoma, Renal Cell - epidemiology
Carcinoma, Renal Cell - mortality
Carcinoma, Renal Cell - secondary
Carcinoma, Renal Cell - surgery
Female
Florida - epidemiology
Follow-Up Studies
Hospital Mortality - trends
Humans
Kidney Neoplasms - epidemiology
Kidney Neoplasms - mortality
Kidney Neoplasms - pathology
Kidney Neoplasms - surgery
Male
Medicine
Medicine & Public Health
Middle Aged
Morbidity
Nephrectomy - mortality
Oncology
Postoperative Complications
Prognosis
Surgery
Surgical Oncology
Survival Rate
Urologic Oncology
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Summary: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  
ISSN:1068-9265
1534-4681
DOI:10.1245/s10434-011-1715-2