Mortality and morbidity after cytoreductive nephrectomy for metastatic XXXX : a population-based study.

@entity1 @entity1358
PURPOSE: To test whether the rates of in-hospital mortality, complications, and transfusions are higher in @entity1 treated with cytoreductive nephrectomy (CNT) for metastatic @entity1358 (mRCC) relative to @entity1 treated with nephrectomy (NT) for non-mRCC. METHODS: We assessed 17,688 @entity1 treated with a NT between years 1999 and 2008, within the Florida Inpatient Database. Chi-square and Student t-tests were used to compare the statistical significance of differences in proportions and means, respectively. Univariable and multivariable logistic regression analyses tested the relationship between surgery type (CNT vs. NT) and three end points: in-hospital mortality, complications, and transfusions. RESULTS: Overall, 6.0% of @entity1 underwent CNT. The rates of in-hospital mortality, complications, and transfusions were 2.4, 26.5, and 24.3% in CNT @entity1 versus 0.9, 18.9, and 11.1% in NT @entity1 . At multivariable analyses, CNT @entity1 demonstrated a 2.0-, 1.3-, and 2.4-fold higher risk of in-hospital mortality, complications, and transfusions (all P < 0.001). Similarly, more advanced age, comorbidity, and the cumulative number of secondary surgical procedures were independent predictors of a higher risk of in-hospital mortality, complications, and transfusions (all P < 0.001). CONCLUSIONS: The rate of in-hospital mortality, complications, and transfusions is higher in @entity1 treated with CNT relative to NT. Older age, higher comorbidity, and the necessity of secondary surgical procedures further increases the risk of all aforementioned end points. Physicians should consider these observations during the planning of a CNT, and @entity1 should be informed accordingly.
