Objective measures of renal mass anatomic complexity predict rates of major complications following partial nephrectomy.

Publication/Presentation Date

10-1-2011

Abstract

BACKGROUND: The association between tumor complexity and postoperative complications after partial nephrectomy (PN) has not been well characterized.

OBJECTIVE: We evaluated whether increasing renal tumor complexity, quantitated by nephrometry score (NS), is associated with increased complication rates following PN using the Clavien-Dindo classification system (CCS).

DESIGN, SETTING, AND PARTICIPANTS: We queried our prospectively maintained kidney cancer database for patients undergoing PN from 2007 to 2010 for whom NS was available.

INTERVENTIONS: All patients underwent PN.

MEASUREMENTS: Tumors were categorized into low- (NS: 4-6), moderate- (NS: 7-9), and high-complexity (NS: 10-12) lesions. Complication rates within 30 d were graded (CCS: I-5), stratified as minor (CCS: I or 2) or major (CCS: 3-5), and compared between groups.

RESULTS AND LIMITATIONS: A total of 390 patients (mean age: 58.0 ± 11.9 yr; 66.9% male) undergoing PN (44.6% open, 55.4% robotic) for low- (28%), moderate- (55.6%), and high-complexity (16.4%) tumors (mean tumor size: 3.74 ± 2.4 cm; median: 3.2 cm) from 2007 to 2010 were identified. Tumor size, estimated blood loss, and ischemia time all significantly differed (p

CONCLUSIONS: Increasing tumor complexity is associated with the development of major complications after PN. This association should be validated externally and integrated into the decision-making process when counseling patients with complex renal tumors.

Volume

60

Issue

4

First Page

724

Last Page

730

ISSN

1873-7560

Disciplines

Medicine and Health Sciences

PubMedID

21621910

Department(s)

Department of Surgery

Document Type

Article

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