Annals of Surgical Oncology

, Volume 18, Issue 10, pp 2988–2996

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

  • Firas Abdollah
  • Maxine Sun
  • Rodolphe Thuret
  • Jan Schmitges
  • Shahrokh F. Shariat
  • Paul Perrotte
  • Francesco Montorsi
  • Pierre I. Karakiewicz
Urologic Oncology

DOI: 10.1245/s10434-011-1715-2

Cite this article as:
Abdollah, F., Sun, M., Thuret, R. et al. Ann Surg Oncol (2011) 18: 2988. doi:10.1245/s10434-011-1715-2

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.

Copyright information

© Society of Surgical Oncology 2011

Authors and Affiliations

  • Firas Abdollah
    • 1
    • 2
  • Maxine Sun
    • 1
  • Rodolphe Thuret
    • 1
    • 3
  • Jan Schmitges
    • 1
    • 4
  • Shahrokh F. Shariat
    • 5
  • Paul Perrotte
    • 1
    • 6
  • Francesco Montorsi
    • 2
  • Pierre I. Karakiewicz
    • 1
    • 6
  1. 1.Cancer Prognostics and Health Outcomes UnitUniversity of Montreal Health CentreMontrealCanada
  2. 2.Department of UrologyVita Salute San Raffaele UniversityMilanItaly
  3. 3.Department of UrologyUniversity of Montpellier Health CentreMontpellierFrance
  4. 4.MartiniclinicUniversity Medical Center Hamburg-EppendorfHamburgGermany
  5. 5.Department of UrologyWeill Medical College of Cornell UniversityNew YorkUSA
  6. 6.Department of UrologyUniversity of Montreal Health CentreMontrealCanada

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