Perioperative outcomes of cytoreductive nephrectomy for metastatic renal cell carcinoma have improved in recent years, investigators concluded in a presentation at the American Urological Association’s 2023 Annual Scientific Meeting in Chicago, Illinois.
Arighno Das, MD, of the University of Wisconsin in Madison, and colleagues analyzed a multi-institutional cohort of 1272 patients who underwent cytoreductive nephrectomy at 6 centers. The cohort included 369 patients from 2005-2009, 557 (44%) from 2010-2014, and 346 (27%) from 2015-2019.
The 90-day mortality rate was significantly lower for the 2015-2019 group compared with the 2005-2009 group (5% vs 10%), Dr Das reported. Moreover, compared with patients who underwent cytoreductive nephrectomy during 2005-2009, those who had the operation during 2015-2019 had a significantly lower overall rate of complications (22% vs 39%) and a lower rate of major complications (Clavien-Dindo 3 or higher) from surgery (10% vs 16%). They had a significantly shorter median hospital stay (4 vs 5 days), but a significantly higher 30-day readmission rate (12% vs 7%).
On multivariable analysis, patients undergoing cytoreductive nephrectomy during 2015-2019 had significant 43% decreased odds of major complications and 51% decreased odds of 90-day mortality compared with patients having the surgery during 2005-2009. Patients treated during 2010-2014 had significant 40% decreased odds of 90-day mortality compared with the 2005-2009 group.
Patients who underwent cytoreductive nephrectomy in 2010-2014 and 2015-2019 were significantly less likely than those treated in 2005-2009 to have received pre-surgical systemic therapy (18% and 18% vs 26%).
Das A, Shapiro D, Karam J, et al. Cytoreductive nephrectomy perioperative outcomes have significantly improved in recent years. Presented at: AUA 2023, Chicago, Illinois, April 28-May 1. Poster MP28-01.