TY - JOUR
T1 - Complications After Metastasectomy for Renal Cell Carcinoma—A Population-based Assessment [Figure presented]
AU - Meyer, Christian P.
AU - Sun, Maxine
AU - Karam, Jose A.
AU - Leow, Jeffrey J.
AU - de Velasco, Guillermo
AU - Pal, Sumanta K.
AU - Chang, Steven L.
AU - Trinh, Quoc Dien
AU - Choueiri, Toni K.
N1 - Publisher Copyright:
© 2017 European Association of Urology
Copyright:
Copyright 2017 Elsevier B.V., All rights reserved.
PY - 2017/8
Y1 - 2017/8
N2 - Metastasectomy has long been considered a valid treatment option for patients with oligometastatic renal cell carcinoma (oligo-mRCC). However, the literature on complications in this setting is scarce. Our objective was to describe in-hospital complications after metastasectomy in a contemporary cohort of patients with mRCC. Using the National Inpatient Sample database (2000–2011), 45 279 mRCC patients were identified. Of those, 1102 underwent metastasectomies. The metastatic sites were the lungs, bone, liver, lymph nodes, adrenal glands, and brain in, respectively, 52%, 29%, 19%, 14%, 11%, and 3.4% of patients. The overall complication rate was 45.7%. Major complications (Clavien III–V) constituted 27.5%. Resections of hepatic lesions were significantly associated with higher odds of overall complications compared with any other site (odds ratio 2.59, 95% confidence interval 1.84–3.62, p < 0.001). While metastasectomy remains a potential treatment option in RCC with oligometastatic disease, the associated complication rates are non-negligible; therefore, careful patient selection is warranted. Patient summary We studied outcomes of patients with metastatic kidney cancer treated with metastasectomy. While metastasectomy is a treatment option for metastatic renal cell carcinoma, complications are not insignificant and our results may guide preoperative counseling.
AB - Metastasectomy has long been considered a valid treatment option for patients with oligometastatic renal cell carcinoma (oligo-mRCC). However, the literature on complications in this setting is scarce. Our objective was to describe in-hospital complications after metastasectomy in a contemporary cohort of patients with mRCC. Using the National Inpatient Sample database (2000–2011), 45 279 mRCC patients were identified. Of those, 1102 underwent metastasectomies. The metastatic sites were the lungs, bone, liver, lymph nodes, adrenal glands, and brain in, respectively, 52%, 29%, 19%, 14%, 11%, and 3.4% of patients. The overall complication rate was 45.7%. Major complications (Clavien III–V) constituted 27.5%. Resections of hepatic lesions were significantly associated with higher odds of overall complications compared with any other site (odds ratio 2.59, 95% confidence interval 1.84–3.62, p < 0.001). While metastasectomy remains a potential treatment option in RCC with oligometastatic disease, the associated complication rates are non-negligible; therefore, careful patient selection is warranted. Patient summary We studied outcomes of patients with metastatic kidney cancer treated with metastasectomy. While metastasectomy is a treatment option for metastatic renal cell carcinoma, complications are not insignificant and our results may guide preoperative counseling.
KW - Clavien–Dindo
KW - Complication
KW - Metastasectomy
KW - Renal cell carcinoma
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U2 - 10.1016/j.eururo.2017.03.005
DO - 10.1016/j.eururo.2017.03.005
M3 - Article
C2 - 28359734
AN - SCOPUS:85016196185
SN - 0302-2838
VL - 72
SP - 171
EP - 174
JO - European urology
JF - European urology
IS - 2
ER -