Complications after kidney cancer surgery are linked with decreased long-term survival
Patient Safety and Quality
In patients with kidney cancer, the partial or total removal of the diseased kidney is the gold standard of care. Despite continued advances in technique, nearly a third of all patients have a complication after surgery. The development of such complications may adversely affect long-term survival, according to a new study. Researchers used National Cancer Institute and Medicare data to identify 12,618 kidney cancer patients who underwent surgery from 1995 to 2005. They identified complications that developed during the hospital stay or within 30 days of surgery. Overall survival was compared for those patients with and without complications to determine any association between the two.
More than one-third (37 percent) of patients studied experienced a complication after surgery. Those with complications tended to be older, male, have coexisting medical conditions, and underwent an open (versus laparoscopic) procedure. During a median followup of 32 months, 37.1 percent of patients died. Patients with at least one complication had a significantly lower unadjusted 5-year survival rate of 59.9 percent compared to non-complication patients (69.5 percent). The relationship continued even after the researchers adjusted for patient characteristics, cancer severity, and surgical approach. Complications independently associated with worse long-term survival included acute renal failure, cardiac and neurological complications, and infection after surgery. The study was supported in part by the Agency for Healthcare Research and Quality (HS18346).
See "Postoperative complications and long-term survival among patients treated surgically for renal cell carcinoma," by Hung-Jui Tan, M.D., Khaled S. Hafez, M.D., Zaojun Ye, M.S., and others in the January 2012 Journal of Urology 187, pp. 60-67.