Prediction of Perioperative XXXX Following Surgery for @entity1358 with Vein Involvement: A Retrospective Study.

@entity1 @entity5 @entity2802 @entity1358 @entity887 @entity3 @entity299 @entity1011 @entity583 @entity204 @entity1851
INTRODUCTION: @entity1358 ( @entity1358 ) shows a propensity for extending into the tributaries of the renal veins, which poses a notable surgical challenge. In this study we addressed the question as to whether @entity1 with @entity1358 and vein involvement can be identified as having a significant risk of immediate @entity204 associated with surgery preoperatively. MATERIALS AND METHODS: A total of 118 @entity1 with @entity1358 and vein involvement from February 1999 until November 2012 were evaluated. The association of early mortality within 60  days after the intervention was tested with various covariates including: age, body mass index (BMI), preoperative serum @entity1851 , preoperative serum @entity1011 , preoperative hemoglobin level, @entity5 diameter, suspicion of @entity3 on prior computed tomography, documented @entity299 , extent of vein invasion, prior @entity583 , @entity2802 stage, American Society of Anesthesiologists score, New York Heart Association classification and Karnofsky index. A multiple logistic regression model was used to test all risk factors including the combination of an elevated BMI with an impaired Karnofsky index with all covariates. RESULTS: A total of 17 @entity1 died within 60  days after the operation with most @entity1 dying from @entity887 during the first two quartiles of the observation, while later deaths were mostly attributable to sequelae of surgical complications. None of the tested risk factors were significantly associated with early mortality in the logistic regression model. The presence of an elevated BMI (>= 30  kg/m(2)) in combination with a Karnofsky index  <=70% predicted @entity204 in univariate (p  =  0.006) and multivariate analysis (p  =  0.023). @entity204 rates for @entity1 with BMI  <30  kg/m(2) and Karnofsky index  >70%, BMI  >=   30  kg/m(2) or Karnofsky index   <=70%, BMI  >= 30  kg/m(2) and Karnofsky index   <=70% were 5%, 14.8% and 37.5%, respectively. CONCLUSION: The risk of @entity204 is dramatically elevated to more than one-third of cases with elevated BMI and unfavorable Karnofsky index in @entity1 with @entity1358 and vein involvement. @entity1 need to be counseled in this regard especially when planning cytoreductive treatment without curative intent.
