RCC Surgery Outcomes Worse in Nutritionally Deficient Patients
Todd M. Morgan, MD
WASHINGTON, D.C.—Nutritional deficiency (ND) is independently associated with higher mortality after surgery for renal cell carcinoma (RCC), according to findings presented at the American Urological Association 2011 annual meeting.
Todd M. Morgan, MD, and collaborators at Vanderbilt Medical Center in Nashville, Tenn., studied 369 patients who underwent partial or radical nephrectomy for RCC. The investigators defined nutritional deficiency as meeting one of the following criteria: BMI less than 18.5 kg/m2, albumin level below 3.5 g/dL, or preoperative weight loss of 5% or more of total body weight. A total of 85 patients (23%) met the ND definition.
The study population had a median age of 61 years. The total median follow-up period was 22.3 months; the median follow-up for surviving patients was 23.6 months.
Three-year overall and disease-specific survival rates were 58.5% and 80.4%, respectively, in the ND cohort compared with 85.4% and 94.7% in the control patients. The differences between the groups were statistically significant.
After adjusting for age, comorbidities and other potential confounders, ND was associated with a 2.8 and 2.4 times increased risk of overall and disease-specific mortality.
Dr. Morgan, who presented study findings, said the findings suggest that preoperative nutritional intervention may have a role in the care of ND patients undergoing RCC surgery.