Contemporary Patients Have Better Perioperative Outcomes Following Cytoreductive Nephrectomy: A Multi-institutional Analysis of 1272 Consecutive Patients

Ashanda R. Esdaille, Jose A. Karam, Viraj A. Master, Philippe E. Spiess, Jay D. Raman, Pranav Sharma, Daniel D. Shapiro, Arighno Das, Wade J. Sexton, Logan Zemp, Dattatraya Patil, Glenn O. Allen, Surena F. Matin, Christopher G. Wood, Jason E. Abel

Research output: Contribution to journalArticlepeer-review

Abstract

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 90 days 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.

Original languageEnglish (US)
Pages (from-to)168-174
Number of pages7
JournalUrology
Volume182
DOIs
StatePublished - Dec 2023

All Science Journal Classification (ASJC) codes

  • Urology

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