Charlson co-morbidity index as a predictor of outcome after surgery for XXXX with renal vein, vena cava or right atrium extension.

@entity1 @entity5 @entity2802 @entity1358 @entity3
PURPOSE: Surgery is the most effective treatment for @entity1358 with @entity5 thrombus but predictors of outcome and @entity1 survival are variable. Co-morbidity may affect therapeutic decision making and survival, although to our knowledge this factor has not been studied in @entity1 with @entity5 thrombus. We analyzed the Charlson co-morbidity index as a predictor of outcome after surgery. MATERIAL AND METHODS: From 1970 to 1998, 303 @entity1 underwent surgical resection. The Charlson index, surgical era, completeness of resection, @entity1 age, sex, @entity5 level, @entity2802 stage, grade and perinephric fat invasion were studied retrospectively as univariate and multivariate predictors of outcome. RESULTS: The level of @entity5 thrombus was 0 (renal vein only) in 127 @entity1 , and I to IV in 66, 58, 36 and 16, respectively. At 5 years overall, cause specific and @entity3 -free survival were 32%, 42% and 41%, while at 10 years they were 21%, 32% and 30%, respectively. For the whole cohort significant multivariate predictors of cause specific survival were @entity3 (p = 0.0001), grade (p = 0.0001), perinephric fat involvement (p = 0.02) and @entity5 levels 0 versus I to IV (p = 0.048). The Charlson index did not predict outcome (univariate model p = 0.65). CONCLUSIONS: Characteristics of the @entity5 remained the most important predictors of cause specific survival in this cohort. The Charlson index did not predict cause specific survival in this cohort of surgically treated @entity1 . Prospective assessment of co-morbidity in @entity1 treated with surgery versus conservative therapy is warranted.
