Incidence and preoperative predictors for major complications following radical nephroureterectomy.

Authors

• Neil J Kocher
• David Canes
• Karim Bensalah
• Morgan Roupret
• Costas Lallas
• Vitaly Margulis
• Shahrokh Shariat
• Pierre Colin
• Surena Matin
• Chad Tracy
• Evanguelos Xylinas
• Andrew Wagner
• Mathieu Roumiguie
• Wassim Kassouf
• Tobias Klatte
• Jay D Raman

Publication/Presentation Date

8-1-2020

Abstract

BACKGROUND: Radical nephroureterectomy (RNU) is the referent standard for managing bulky, invasive, or high grade upper-tract urothelial carcinoma (UTUC). The UTUC patient population, however, generally harbor medical comorbidities thereby placing them at risk of surgical complications. This study reviews a large international cohort of RNU patients to define the risk of major complications and preoperative factors associated with their occurrence.

METHODS: Patients undergoing RNU at 14 academic medical centers between 2002 and 2015 were retrospectively reviewed. Preoperative clinical, demographic, operative, and comorbidity indices were recorded. The modified Clavien-Dindo index was used to grade complications occurring within 30 days of surgery. The association between preoperative variables and major complications occurring after RNU was determined by multivariable logistic regression.

RESULTS: One thousand two hundred and sixty-six patients (707 men; 559 women) with a median age of 70 years and BMI of 27 kg/m

CONCLUSIONS: Major complications following RNU occurred in almost 10% of patients. Impaired preoperative performance status and baseline CKD are preoperative variables associated with these major post-surgical adverse event. These easily measurable indices warrant consideration and discussion prior to proceeding with RNU.

Volume

9

Issue

4

First Page

1786

Last Page

1793

ISSN

2223-4691

Published In/Presented At

Kocher, N. J., Canes, D., Bensalah, K., Roupret, M., Lallas, C., Margulis, V., Shariat, S., Colin, P., Matin, S., Tracy, C., Xylinas, E., Wagner, A., Roumiguie, M., Kassouf, W., Klatte, T., & Raman, J. D. (2020). Incidence and preoperative predictors for major complications following radical nephroureterectomy. Translational andrology and urology, 9(4), 1786–1793. https://doi.org/10.21037/tau.2020.01.22

Disciplines

Business Administration, Management, and Operations | Health and Medical Administration | Management Sciences and Quantitative Methods

PubMedID

32944541

Department(s)

Administration and Leadership

Document Type

Article