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Operative mortality after nephrectomy for renal cell carcinoma
Asgeir Thoroddsen1, Tomas Gudbjartsson, Eirikur Jonsson
1Department of Urology, Faculty of Medicine, Landspitali University Hospital, University of Iceland, Reykjavik, Iceland.
Scandinavian Journal of Urology and Nephrology
|December 17, 2003
Summary
Operative mortality after kidney cancer surgery (nephrectomy) remained low in Iceland over 30 years. Bleeding and infections were the main causes of death, supporting palliative nephrectomy for advanced renal cell carcinoma (RCC).
Area of Science:
- Urology
- Oncology
- Surgical Pathology
Background:
- Renal cell carcinoma (RCC) is a significant health concern.
- Nephrectomy is a primary treatment for RCC.
- Understanding operative mortality is crucial for patient outcomes.
Purpose of the Study:
- To determine the rate and causes of operative mortality after nephrectomy for RCC in Iceland.
- To analyze trends in mortality over a 30-year period.
- To evaluate the impact of palliative vs. curative intent on mortality.
Main Methods:
- Retrospective, population-based study of 575 patients undergoing nephrectomy for RCC (1971-2000).
- Analysis of patients who died within 30 days post-surgery.
- Comparison of demographic and clinical factors between deceased and surviving patients.
- Review of autopsy records for cause of death determination.
Main Results:
- Operative mortality (OM) was 2.8% and remained stable over 30 years.
- Patients with OM were older (73 vs. 64 years).
- Perioperative bleeding and infections were the most common causes of death.
Conclusions:
- Nephrectomy for RCC in Iceland has a consistently low operative mortality rate.
- Perioperative bleeding and infections are the primary contributors to OM.
- Palliative nephrectomy is a viable treatment option for advanced RCC, supported by low OM in metastatic patients.