PD59-08 INTERNATIONAL MULTI-INSTITUTIONAL CHARACTERIZATION OF THE PERIOPERATIVE MORBIDITY OF METASTASECTOMY FOR RENAL CELL CARCINOMA

Abstract

You have accessJournal of UrologyCME1 May 2022PD59-08 INTERNATIONAL MULTI-INSTITUTIONAL CHARACTERIZATION OF THE PERIOPERATIVE MORBIDITY OF METASTASECTOMY FOR RENAL CELL CARCINOMA Timothy Lyon, Eduard Roussel, Vidit Sharma, Gianpiero Carames, Christine Lohse, Stephen Boorjian, Houston Thompson, Steven Joniau, Maarten Albersen, Leuven Belgium, and Bradley Leibovich Timothy LyonTimothy Lyon More articles by this author , Eduard RousselEduard Roussel More articles by this author , Vidit SharmaVidit Sharma More articles by this author , Gianpiero CaramesGianpiero Carames More articles by this author , Christine LohseChristine Lohse More articles by this author , Stephen BoorjianStephen Boorjian More articles by this author , Houston ThompsonHouston Thompson More articles by this author , Steven JoniauSteven Joniau More articles by this author , Maarten AlbersenMaarten Albersen More articles by this author , Leuven BelgiumLeuven Belgium More articles by this author , and Bradley LeibovichBradley Leibovich More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002644.08AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Although complete surgical resection of metastatic renal cell carcinoma (mRCC) has been associated with improved cancer-specific survival, high-quality data on its perioperative morbidity are lacking. The existing population-based data are severely limited by reliance on billing claims to identify outcomes, which may overestimate events due to lack of code specificity. Therefore, the objective of this study was to evaluate 30-day complications after metastasectomy from two high-volume surgical centers. METHODS: Prospectively maintained nephrectomy registries at Mayo Clinic and UZ Leuven were queried to identify adults who underwent a metastasectomy for mRCC between 2006 and 2020. Records were retrospectively reviewed to identify a comprehensive list of over 40 possible complications within 30 days of surgery classified according to the Clavien-Dindo system, with grade III-V complications considered major. Associations of features with postoperative complications were evaluated using conditional logistic regression models with center as a stratification variable. RESULTS: A total of 740 metastasectomies in 522 patients were identified, including 543 contributed by Mayo Clinic and 197 by UZ Leuven. Among the 740 metastasectomies, 193 (26%; 95% CI 23-29%) had a 30-day complication and 62 (8%; 95% CI 7-11%) had a major complication, including eight (1%) perioperative deaths. Age, BMI, ASA score, metastasectomy concurrent with nephrectomy, multiple sites of metastasis, pancreatic metastasis, and size of metastasis were significantly associated with postoperative complications (Table 1). Similarly, age, multiple sites of metastasis, and pancreatic metastasis were significantly associated with major complications (Table 1). The addition of the indicator for complete metastasectomy and all two-way interactions with this feature was not statistically significant (p ≥ 0.2). CONCLUSIONS: In this multi-institutional cohort fewer than 10% of metastasectomies for mRCC resulted in a major complication within 30 days, which is considerably lower than reported in population-based data. Along with increasing age and comorbidity, patients with multiple sites of disease or those who harbor pancreatic metastases are at highest risk of postoperative morbidity. Source of Funding: None © 2022 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 207Issue Supplement 5May 2022Page: e1021 Advertisement Copyright & Permissions© 2022 by American Urological Association Education and Research, Inc.MetricsAuthor Information Timothy Lyon More articles by this author Eduard Roussel More articles by this author Vidit Sharma More articles by this author Gianpiero Carames More articles by this author Christine Lohse More articles by this author Stephen Boorjian More articles by this author Houston Thompson More articles by this author Steven Joniau More articles by this author Maarten Albersen More articles by this author Leuven Belgium More articles by this author Bradley Leibovich More articles by this author Expand All Advertisement PDF DownloadLoading ...