FREE DAILY AND WEEKLY NEWSLETTERS OFFERED BY CONTENT OF INTEREST
Did you find this article relevant? Subscribe to UroToday-GUOncToday!
The fields of GU Oncology and Urology are advancing rapidly including new treatments, enrolling clinical trials, screening and surveillance recommendations along with updated guidelines. Join us as one of our subscribers who rely on UroToday as their must-read source for the latest news and data on drugs. Sign up today for blogs, video conversations, conference highlights and abstracts from peer-review publications by disease and condition delivered to your inbox and read on the go.
In total, 7800 patients were included in the study who met both the inclusion and exclusion criteria. The results of the study revealed that patients with disseminated cancer were more likely to be young, male, Caucasian, have a low BMI, active smokers, and have a higher ASA class. These patients were also less likely to undergo minimally invasive surgery, have higher proportions undergoing a concurrent procedure, and have an increase occurrence of bowel procedures, splenectomy, hepatectomy, and major vascular repair when compared to those without disseminated cancer. Patients with disseminated cancer is associated with greater risks of major complications including higher mortality and reoperation, as well as pulmonary complications, infections, thromboembolism, bleeding complications, and prolong length of stay.
In conclusion, nephrectomy in patients with disseminated cancer is associated with significant perioperative morbidity and mortality. The results of this study may be used for preoperative counseling of patients undergoing CN. Future studies should continue to work on optimizing patient selection for oncological benefits and to minimize perioperative complications. Some significant limitations of the study includes NSQIP lack of cancer-specific information, and the study lacked variables necessary to understand patient symptoms or tumor burden.
Authors: Christopher J. D. Wallis, Georg Bjarnason, James Byrne, Douglas C. Cheung, Azik Hoffman, Girish S. Kulkarni, Avery B. Nathens, Robert K. Nam, and Raj Satkunasivam
Read the Abstract
1. Heng DY, Wells JC, Rini BI, et al. Cytoreductive nephrectomy in patients with synchronous metastases from renal cell carcinoma: results from the International Metastatic Renal Cell Carcinoma Database Consortium. Eur Urol. 2014;66:704-710.
2. Choueiri TK, Xie W, Kollmannsberger C, et al. The impact of cytoreductive nephrectomy on survival of patients with metastatic renal cell carcinoma receiving vascular endothelial growth factor targeted. J Urol. 2011;185:60-66.
3. Corcoran AT, Kaffenberger SD, Clark PE, et al. Hypoalbuminaemia is associated with mortality in patients undergoing cytoreductive nephrectomy. BJU Int. 2015;116:351-357.
4. Gershman B, Moreira DM, Boorjian SA, et al. Comprehensive characterization of the perioperative morbidity of cytoreductive nephrectomy. Eur Urol. 2016;69:84-91.
5. Silberstein JL, Adamy A, Maschino AC, et al. Systematic classification and prediction of complications after nephrectomy in patients with metastatic renal cell carcinoma (RCC). BJU Int. 2012;110:1276-1282.
6. Jackson BL, Fowler S, Williams ST; British Association of Urological Surgeons—Section of Oncology. Perioperative outcomes of cytoreductive nephrectomy in the UK in 2012. BJU Int. 2015;116:905-910.
7. Sun M, Abdollah F, Schmitges J, et al. Cytoreductive nephrectomy in the elderly: a population-based cohort from the USA. BJU Int. 2012;109:1807-1812.
8. Trinh QD, Bianchi M, Hansen J, et al. In-hospital mortality and failure to rescue after cytoreductive nephrectomy. Eur Urol. 2013;63:1107-1114.