You have accessJournal of UrologyKidney Cancer: Advanced (II)1 Apr 20131922 CONTEMPORARY MORBIDITY RELATED OUTCOMES OF NEPHRECTOMY AND IVC THROMBECTOMY FOR RCC USING A VALIDATED COMPLICATION TOOL Tony Kurian, Patrick N Espiritu, Timothy J Kim, Yin Zheng, Wade J Sexton, Julio M Pow-Sang, Devanand Mangar, Paul Armstrong, and Philippe E Spiess Tony KurianTony Kurian Tampa, FL More articles by this author , Patrick N EspirituPatrick N Espiritu Tampa, FL More articles by this author , Timothy J KimTimothy J Kim Tampa, FL More articles by this author , Yin ZhengYin Zheng Tampa, FL More articles by this author , Wade J SextonWade J Sexton Tampa, FL More articles by this author , Julio M Pow-SangJulio M Pow-Sang Tampa, FL More articles by this author , Devanand MangarDevanand Mangar Tampa, FL More articles by this author , Paul ArmstrongPaul Armstrong Tampa, FL More articles by this author , and Philippe E SpiessPhilippe E Spiess Tampa, FL More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2013.02.2341AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Renal cell carcinoma (RCC) associated with venous tumor thrombus often requires a multidisciplinary surgical approach for higher level inferior vena cava (IVC) tumor thrombi. Although potentially curative, very little has been reported on the outcomes of patients undergoing such procedures using valid complication tools such as the Clavien-Dindo system. The aim of the present study is to assess this clinical question within our patient cohort. METHODS A retrospective IRB protocol was approved prior to conducting the present study. A total of 125 consecutive patients underwent nephrectomy and IVC thrombectomy in the context of RCC at our respective center from 11/1989 to 5/2012, and they are the basis of this report. We categorized all perioperative complications using the validated prognostic Clavien-Dindo system. For patients who experienced multiple complications, we report the highest grade of complication. Events occurring within 30 days of the date of surgery were considered peri-operative complications. For the purposes of this study, we defined grade I and II complications as minor complications as they required no interventional procedure(s) whereas complications grade III or higher were considered major complications. RESULTS The patient cohort consisted of 125 patients, with a median age at presentation of 64 years. The male to female preponderance of cases were 89 (71%) and 36 (29%), respectively. The level of thrombus was I in 37 patients, II in 41 patients, III in 26 patients, and IV in 21 patients. Sixty-four patients (51%) experienced 83 complications. Of these, 34 (53%) were minor complications and 30 (47%) were major complications. The incidence of peri-operative complications for patients presenting with level I, II, III, and IV tumor thrombus were 51%, 44%, 58%, and 57%, respectively. Complication rates were not associated with the level of IVC tumor thrombus (p = 0.66). Overall peri-operative mortality rate was 9% (11 patients). Mortality rates were 5%, 15%, 4%, and 10% for patients with level I, level II, level III, and level IV thrombus, respectively. Mortality was not associated with level of thrombus (p = 0.38). Median follow-up was 16 months. CONCLUSIONS Significant morbidity and mortality is associated with nephrectomy with IVC thrombectomy. Importantly, neither mortality nor complications were associated with the proximal level of the IVC tumor thrombus. © 2013 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 189Issue 4SApril 2013Page: e788 Advertisement Copyright & Permissions© 2013 by American Urological Association Education and Research, Inc.MetricsAuthor Information Tony Kurian Tampa, FL More articles by this author Patrick N Espiritu Tampa, FL More articles by this author Timothy J Kim Tampa, FL More articles by this author Yin Zheng Tampa, FL More articles by this author Wade J Sexton Tampa, FL More articles by this author Julio M Pow-Sang Tampa, FL More articles by this author Devanand Mangar Tampa, FL More articles by this author Paul Armstrong Tampa, FL More articles by this author Philippe E Spiess Tampa, FL More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...