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Renal Function After Retroperitoneal Sarcoma Resection with Nephrectomy: A Matched Analysis of the United States
Christopher C Stahl1, Patrick B Schwartz2, Cecilia G Ethun3
1Department of Surgery, University of Wisconsin, Madison, WI, USA. cstahl@uwhealth.org.
Annals of Surgical Oncology
|November 4, 2020
Summary
Nephrectomy during retroperitoneal sarcoma resection increases the risk of acute kidney injury and acute renal failure. Postoperative dialysis risk remains low for patients undergoing this procedure.
Area of Science:
- Oncology
- Nephrology
- Surgical Oncology
Background:
- Retroperitoneal sarcoma (RPS) resection often necessitates nephrectomy for complete tumor removal.
- The impact of nephrectomy on kidney function in RPS patients, especially those receiving nephrotoxic therapies, is not well-defined.
Purpose of the Study:
- To evaluate the impact of nephrectomy on postoperative renal function after retroperitoneal sarcoma resection.
- To assess the incidence of acute kidney injury (AKI), acute renal failure (ARF), and dialysis post-nephrectomy in RPS patients.
Main Methods:
- A retrospective analysis of the United States Sarcoma Collaborative (USSC) database (2000-2016).
- Matched cohort analysis using coarsened exact matching and weighted logistic regression.
- Primary outcomes included postoperative AKI, ARF, and dialysis.
Main Results:
- Nephrectomy was associated with significantly higher rates of postoperative AKI (14.8% vs. 4.3%) and ARF (4.6% vs. 1.3%).
- Logistic regression confirmed a persistent increased risk of AKI (OR 5.16) and ARF (OR 5.04) after nephrectomy.
- No patients in the matched cohort required postoperative dialysis, regardless of nephrectomy status.
Conclusions:
- Nephrectomy during RPS resection is linked to a higher risk of postoperative AKI and ARF.
- The risk of requiring postoperative dialysis appears to be low (≤0.5%) irrespective of nephrectomy.
- Further research may be needed to fully elucidate long-term renal function outcomes.
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