Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
SHR Neuro Krebs Kardio Lipid Stoffw Microb
González, J; Gaynor, JJ; Martínez-Salamanca, JI; Capitanio, U; Tilki, D; Carballido, JA; Chantada, V; Daneshmand, S; Evans, CP; Gasch, C; Gontero, P; Haferkamp, A; Huang, WC; Espinós, EL; Master, VA; McKiernan, JM; Montorsi, F; Pahernik, S; Palou, J; Pruthi, RS; Rodriguez-Faba, O; Russo, P; Scherr, DS; Shariat, SF; Spahn, M; Terrone, C; Vera-Donoso, C; Zigeuner, R; Hohenfellner, M; Libertino, JA; Ciancio, G.
Association of an organ transplant-based approach with a dramatic reduction in postoperative complications following radical nephrectomy and tumor thrombectomy in renal cell carcinoma.
Eur J Surg Oncol. 2019; 45(10):1983-1992
Doi: 10.1016/j.ejso.2019.05.009
[OPEN ACCESS]
Web of Science
PubMed
FullText
FullText_MUG
- Co-Autor*innen der Med Uni Graz
- Zigeuner Richard
- Altmetrics:
- Dimensions Citations:
- Plum Analytics:
- Scite (citation analytics):
- Abstract:
- Our aim was to determine whether using an organ transplant-based(TB) approach reduces postoperative complications(PCs) following radical nephrectomy(RN) and tumor thrombectomy(TT) in renal cell carcinoma(RCC) patients with level II-IV thrombi. A total of 390(292 non-TB/98 TB) IRCC-VT Consortium patients who received no preoperative embolization/IVC filter were included. Stepwise linear/logistic regression analyses were performed to determine significant multivariable predictors of intraoperative estimated blood loss(IEBL), number blood transfusions received, and overall/major PC development within 30days following surgery. Propensity to receive the TB approach was controlled. The TB approach was clearly superior in limiting IEBL, blood transfusions, and PC development, even after controlling for other significant prognosticators/propensity score(P < .000001 in each case). Median IEBL for non-TB/TB approaches was 1000 cc/300 cc and 1500 cc/500 cc for tumor thrombus Level II-III patients, respectively, with no notable differences for Level IV patients(2000 cc each). In comparing PC outcomes between non-TB/TB patients with a non-Right-Atrium Cranial Limit, the observed percentage developing a: i) PC was 65.8%(133/202) vs. 4.3%(3/69) for ECOG Performance Status(ECOG-PS) 0-1, and 84.8%(28/33) vs. 25.0%(4/16) for ECOG-PS 2-4, and ii) major PC was 16.8%(34/202) vs. 1.4%(1/69) for ECOG-PS 0-1, and 27.3%(9/33) vs. 12.5%(2/16) for ECOG-PS 2-4. Major study limitation was the fact that all TB patients were treated by a single, experienced, high volume surgeon from one center (non-TB patients were treated by various surgeons at 13 other centers). Despite this major study limitation, the observed dramatic differences in PC outcomes suggest that the TB approach offers a major breakthrough in limiting operative morbidity in RCC patients receiving RN and TT. Copyright © 2019. Published by Elsevier Ltd.
- Find related publications in this database (using NLM MeSH Indexing)
- Blood Transfusion - methods
- Carcinoma, Renal Cell - complications
- Carcinoma, Renal Cell - diagnosis
- Carcinoma, Renal Cell - surgery
- Female -
- Follow-Up Studies -
- Humans -
- Kidney Neoplasms - complications
- Kidney Neoplasms - surgery
- Male -
- Middle Aged -
- Nephrectomy - adverse effects
- Postoperative Complications - etiology
- Postoperative Complications - prevention & control
- Retrospective Studies -
- Thrombectomy - methods
- Thrombosis - etiology
- Thrombosis - surgery
- Vena Cava, Inferior -
- Find related publications in this database (Keywords)
- Renal cell carcinoma
- Inferior vena cava
- Tumor thrombus
- Surgical technique
- Postoperative complications