Incidence and preoperative predictors for major complications following radical nephroureterectomy.

Authors

Neil J Kocher, Penn State Health Milton S. Hershey Medical Center
David Canes, Lahey Clinic Hospital and Medical Center
Karim Bensalah, University of Rennes
Morgan Roupret, Pierre and Marie Curie University
Costas Lallas, Thomas Jefferson UniversityFollow
Vitaly Margulis, The University of Texas Southwestern
Shahrokh Shariat, Medical University of Vienna
Pierre Colin, La Louviere Private Hospital
Surena Matin, The University of Texas MD Anderson Cancer Center
Chad Tracy, University of Iowa Hospitals and Clinics
Evanguelos Xylinas, Cochin Hospital
Andrew Wagner, Beth Israel Deaconess Medical Center
Mathieu Roumiguie, Centre Hospitalier Universitaire de Toulouse
Wassim Kassouf, McGill University Health Center
Tobias Klatte, Medical University of Vienna
Jay D Raman, Penn State Health Milton S. Hershey Medical Center

Document Type

Article

Publication Date

8-1-2020

Comments

This is the final published version of the article from Translational Andrology and Urology, 2020, Volume 9, Issue 4, Pages 1786-1793.

The article can also be accessed at: http://dx.doi.org/10.21037/tau.2020.01.22

Copyright, Translational Andrology and Urology

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.

Recommended Citation

Kocher, Neil J; Canes, David; Bensalah, Karim; Roupret, Morgan; Lallas, Costas; Margulis, Vitaly; Shariat, Shahrokh; Colin, Pierre; Matin, Surena; Tracy, Chad; Xylinas, Evanguelos; Wagner, Andrew; Roumiguie, Mathieu; Kassouf, Wassim; Klatte, Tobias; and Raman, Jay D, "Incidence and preoperative predictors for major complications following radical nephroureterectomy." (2020). Department of Urology Faculty Papers. Paper 61.
https://jdc.jefferson.edu/urologyfp/61

Creative Commons License

This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.

PubMed ID

32944541

Language

English