MP28-01 CYTOREDUCTIVE NEPHRECTOMY PERIOPERATIVE OUTCOMES HAVE SIGNIFICANTLY IMPROVED IN RECENT YEARS

Abstract

You have accessJournal of UrologyCME1 Apr 2023MP28-01 CYTOREDUCTIVE NEPHRECTOMY PERIOPERATIVE OUTCOMES HAVE SIGNIFICANTLY IMPROVED IN RECENT YEARS Arighno Das, Daniel Shapiro, Jose Karam, Viraj Master, Philippe Spiess, Jay Raman, Ashanda Esdaille, Logan Zemp, Pranav Sharma, Wade Sexton, Datta Patil, Glenn Allen, Surena Matin, and E. Jason Abel Arighno DasArighno Das More articles by this author , Daniel ShapiroDaniel Shapiro More articles by this author , Jose KaramJose Karam More articles by this author , Viraj MasterViraj Master More articles by this author , Philippe SpiessPhilippe Spiess More articles by this author , Jay RamanJay Raman More articles by this author , Ashanda EsdailleAshanda Esdaille More articles by this author , Logan ZempLogan Zemp More articles by this author , Pranav SharmaPranav Sharma More articles by this author , Wade SextonWade Sexton More articles by this author , Datta PatilDatta Patil More articles by this author , Glenn AllenGlenn Allen More articles by this author , Surena MatinSurena Matin More articles by this author , and E. Jason AbelE. Jason Abel More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003256.01AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Few data are available describing perioperative outcomes for cytoreductive nephrectomy (CN) or how changes in patient selection may have impacted modern cohorts. This study investigated factors associated with perioperative outcomes in a multi-institutional cohort of patients treated with CN. METHODS: Data was analyzed for metastatic renal cell carcinoma patients treated with CN at 6 tertiary centers from 2005-2019. Outcomes included: Clavien-Dindo complications, mortality, length of hospitalization, and 30-day readmission rate. Multivariable logistic regression was used to evaluate variables associated with perioperative outcomes. Patients were stratified into 3 equal time periods to evaluate changes in outcomes over time. RESULTS: A total of 1,272 patients were treated with CN at 6 centers including 369 (29%) from 2005-2009, 557 (44%) from 2010-2014, and 346 (27%) from 2015-2019. Patients treated in 2015-2019 vs 2005-2009 were less likely to have received pre-surgical systemic therapy (19% vs 26%, p=0.02). Perioperative outcomes are shown in Table. Mortality at 90 days was lower for patients treated in 2015-2019 vs 2005-2009 (5% vs 10%, p=0.02). Patients treated in 2015-2019 vs 2005-2009 had lower overall (22% vs 39%, p<0.001) and major (Clavien-Dindo ≥ 3) complications from surgery (10% vs 16%, p=0.02). Median hospital stay was shorter for patients treated 2015-2019 vs 2005-2009 (4 days vs 5 days, p<0.001) but 30-day readmission rate was also higher (12% vs 7%, p=0.02). On multivariable analysis, patients undergoing CN in 2015-2019 had significantly lower odds of major complications (OR 0.57, 95%CI 0.36-0.90) and 90-day mortality (OR 0.49, 95%CI 0.27-0.89) compared to undergoing CN in 2005-2009. Receipt of presurgical systemic therapy was not associated with increased odds of high-grade complications (OR 0.79, 95%CI 0.52-1.19). CONCLUSIONS: In this large multi-institutional study, perioperative complications have significantly decreased over time. Prospective studies should investigate how to further improve outcomes and select patients. Source of Funding: N/A © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e369 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Arighno Das More articles by this author Daniel Shapiro More articles by this author Jose Karam More articles by this author Viraj Master More articles by this author Philippe Spiess More articles by this author Jay Raman More articles by this author Ashanda Esdaille More articles by this author Logan Zemp More articles by this author Pranav Sharma More articles by this author Wade Sexton More articles by this author Datta Patil More articles by this author Glenn Allen More articles by this author Surena Matin More articles by this author E. Jason Abel More articles by this author Expand All Advertisement PDF downloadLoading ...