Laparoscopic Radical Nephrectomy vs Laparoscopic or Open Partial Nephrectomy for T1 Renal Cell Carcinoma: Comparison of Complication Rates in Elderly Patients During the Initial Phase of Adoption

Andreas Becker; Praful Ravi; Florian Roghmann; Quoc-Dien Trinh; Zhe Tian; Alexandre Larouche; Simon Kim; Shahrokh F Shariat; Luis Kluth; Roland Dahlem; Margit Fisch; Markus Graefen; Christian Eichelberg; Pierre I Karakiewicz; Maxine Sun

doi:10.1016/j.urology.2014.01.050

Laparoscopic Radical Nephrectomy vs Laparoscopic or Open Partial Nephrectomy for T1 Renal Cell Carcinoma

Standard

Laparoscopic Radical Nephrectomy vs Laparoscopic or Open Partial Nephrectomy for T1 Renal Cell Carcinoma : Comparison of Complication Rates in Elderly Patients During the Initial Phase of Adoption. / Becker, Andreas; Ravi, Praful; Roghmann, Florian; Trinh, Quoc-Dien; Tian, Zhe; Larouche, Alexandre; Kim, Simon; Shariat, Shahrokh F; Kluth, Luis; Dahlem, Roland ; Fisch, Margit; Graefen, Markus; Eichelberg, Christian; Karakiewicz, Pierre I; Sun, Maxine.

In: UROLOGY, Vol. 83, No. 6, 01.06.2014, p. 1285-1291.

Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review

Harvard

Becker, A, Ravi, P, Roghmann, F, Trinh, Q-D, Tian, Z, Larouche, A, Kim, S, Shariat, SF, Kluth, L, Dahlem, R , Fisch, M, Graefen, M, Eichelberg, C, Karakiewicz, PI & Sun, M 2014, 'Laparoscopic Radical Nephrectomy vs Laparoscopic or Open Partial Nephrectomy for T1 Renal Cell Carcinoma: Comparison of Complication Rates in Elderly Patients During the Initial Phase of Adoption', UROLOGY, vol. 83, no. 6, pp. 1285-1291. https://doi.org/10.1016/j.urology.2014.01.050

APA

Becker, A., Ravi, P., Roghmann, F., Trinh, Q-D., Tian, Z., Larouche, A., Kim, S., Shariat, S. F., Kluth, L., Dahlem, R., Fisch, M., Graefen, M., Eichelberg, C., Karakiewicz, P. I., & Sun, M. (2014). Laparoscopic Radical Nephrectomy vs Laparoscopic or Open Partial Nephrectomy for T1 Renal Cell Carcinoma: Comparison of Complication Rates in Elderly Patients During the Initial Phase of Adoption. UROLOGY, 83(6), 1285-1291. https://doi.org/10.1016/j.urology.2014.01.050

Vancouver

Becker A, Ravi P, Roghmann F, Trinh Q-D, Tian Z, Larouche A et al. Laparoscopic Radical Nephrectomy vs Laparoscopic or Open Partial Nephrectomy for T1 Renal Cell Carcinoma: Comparison of Complication Rates in Elderly Patients During the Initial Phase of Adoption. UROLOGY. 2014 Jun 1;83(6):1285-1291. https://doi.org/10.1016/j.urology.2014.01.050

Bibtex

@article{ca6a567dd00b4576841474ddeda04bb8,

title = "Laparoscopic Radical Nephrectomy vs Laparoscopic or Open Partial Nephrectomy for T1 Renal Cell Carcinoma: Comparison of Complication Rates in Elderly Patients During the Initial Phase of Adoption",

abstract = "OBJECTIVE: To assess postoperative complication profiles and 30-day mortality (30 dM) in older patients undergoing either laparoscopic radical nephrectomy (LRN) compared with open partial nephrectomy (OPN) or laparoscopic partial nephrectomy (LPN) for early stage renal cell carcinoma.METHODS: Using the Surveillance, Epidemiology, and End Results-Medicare linked database, 2277 patients aged >65 years with T1 renal cell carcinoma, who underwent LRN, OPN, or LPN were identified (1992-2005). Surgical and medical complications and 30 dM after nephrectomy were abstracted. Bivariate and multivariate logistic regression analyses were performed.RESULTS: Relative to LRN, the rate of surgical complications was higher for OPN (28% vs 20%; P <.001) and LPN (29% vs 20%; P = .01). These differences persisted after multivariate adjustment for patient and tumor characteristics (OPN: odds ratio, 1.6; 95% confidence interval, 1.28-1.91; P <.001; LPN: odds ratio, 1.6; 95% confidence interval, 1.13-2.39; P = .01). Specifically, relative to LRN, OPN was associated with a 7% higher rate of genitourinary complications (13% vs 20%; P <.001). Similarly, relative to LRN, LPN was associated with a 7% higher rate of genitourinary complications (13% vs 20%; P = .001) and with a 4% higher rate of hemorrhagic complications (8% vs 4%; P = .02). No statistically significant differences were recorded for all other surgical and/or medical complication types and 30 dM (all P ≥.2).CONCLUSION: The complication and 30-dM rates were not different between LRN, OPN, and LPN groups. Exceptions include genitourinary complications that favor LRN relative to OPN and LPN and hemorrhagic complications that favor LRN relative to LPN. It is doubtful that these results should discourage the use of partial nephrectomy relative to LRN in older patients.",

author = "Andreas Becker and Praful Ravi and Florian Roghmann and Quoc-Dien Trinh and Zhe Tian and Alexandre Larouche and Simon Kim and Shariat, {Shahrokh F} and Luis Kluth and Roland Dahlem and Margit Fisch and Markus Graefen and Christian Eichelberg and Karakiewicz, {Pierre I} and Maxine Sun",

year = "2014",

month = jun,

day = "1",

doi = "10.1016/j.urology.2014.01.050",

language = "English",

volume = "83",

pages = "1285--1291",

journal = "UROLOGY",

issn = "0090-4295",

publisher = "Elsevier Inc.",

number = "6",

}

RIS

TY - JOUR

T1 - Laparoscopic Radical Nephrectomy vs Laparoscopic or Open Partial Nephrectomy for T1 Renal Cell Carcinoma

T2 - Comparison of Complication Rates in Elderly Patients During the Initial Phase of Adoption

AU - Becker, Andreas

AU - Ravi, Praful

AU - Roghmann, Florian

AU - Trinh, Quoc-Dien

AU - Tian, Zhe

AU - Larouche, Alexandre

AU - Kim, Simon

AU - Shariat, Shahrokh F

AU - Kluth, Luis

AU - Dahlem, Roland

AU - Fisch, Margit

AU - Graefen, Markus

AU - Eichelberg, Christian

AU - Karakiewicz, Pierre I

AU - Sun, Maxine

PY - 2014/6/1

Y1 - 2014/6/1

N2 - OBJECTIVE: To assess postoperative complication profiles and 30-day mortality (30 dM) in older patients undergoing either laparoscopic radical nephrectomy (LRN) compared with open partial nephrectomy (OPN) or laparoscopic partial nephrectomy (LPN) for early stage renal cell carcinoma.METHODS: Using the Surveillance, Epidemiology, and End Results-Medicare linked database, 2277 patients aged >65 years with T1 renal cell carcinoma, who underwent LRN, OPN, or LPN were identified (1992-2005). Surgical and medical complications and 30 dM after nephrectomy were abstracted. Bivariate and multivariate logistic regression analyses were performed.RESULTS: Relative to LRN, the rate of surgical complications was higher for OPN (28% vs 20%; P <.001) and LPN (29% vs 20%; P = .01). These differences persisted after multivariate adjustment for patient and tumor characteristics (OPN: odds ratio, 1.6; 95% confidence interval, 1.28-1.91; P <.001; LPN: odds ratio, 1.6; 95% confidence interval, 1.13-2.39; P = .01). Specifically, relative to LRN, OPN was associated with a 7% higher rate of genitourinary complications (13% vs 20%; P <.001). Similarly, relative to LRN, LPN was associated with a 7% higher rate of genitourinary complications (13% vs 20%; P = .001) and with a 4% higher rate of hemorrhagic complications (8% vs 4%; P = .02). No statistically significant differences were recorded for all other surgical and/or medical complication types and 30 dM (all P ≥.2).CONCLUSION: The complication and 30-dM rates were not different between LRN, OPN, and LPN groups. Exceptions include genitourinary complications that favor LRN relative to OPN and LPN and hemorrhagic complications that favor LRN relative to LPN. It is doubtful that these results should discourage the use of partial nephrectomy relative to LRN in older patients.

AB - OBJECTIVE: To assess postoperative complication profiles and 30-day mortality (30 dM) in older patients undergoing either laparoscopic radical nephrectomy (LRN) compared with open partial nephrectomy (OPN) or laparoscopic partial nephrectomy (LPN) for early stage renal cell carcinoma.METHODS: Using the Surveillance, Epidemiology, and End Results-Medicare linked database, 2277 patients aged >65 years with T1 renal cell carcinoma, who underwent LRN, OPN, or LPN were identified (1992-2005). Surgical and medical complications and 30 dM after nephrectomy were abstracted. Bivariate and multivariate logistic regression analyses were performed.RESULTS: Relative to LRN, the rate of surgical complications was higher for OPN (28% vs 20%; P <.001) and LPN (29% vs 20%; P = .01). These differences persisted after multivariate adjustment for patient and tumor characteristics (OPN: odds ratio, 1.6; 95% confidence interval, 1.28-1.91; P <.001; LPN: odds ratio, 1.6; 95% confidence interval, 1.13-2.39; P = .01). Specifically, relative to LRN, OPN was associated with a 7% higher rate of genitourinary complications (13% vs 20%; P <.001). Similarly, relative to LRN, LPN was associated with a 7% higher rate of genitourinary complications (13% vs 20%; P = .001) and with a 4% higher rate of hemorrhagic complications (8% vs 4%; P = .02). No statistically significant differences were recorded for all other surgical and/or medical complication types and 30 dM (all P ≥.2).CONCLUSION: The complication and 30-dM rates were not different between LRN, OPN, and LPN groups. Exceptions include genitourinary complications that favor LRN relative to OPN and LPN and hemorrhagic complications that favor LRN relative to LPN. It is doubtful that these results should discourage the use of partial nephrectomy relative to LRN in older patients.

U2 - 10.1016/j.urology.2014.01.050

DO - 10.1016/j.urology.2014.01.050

M3 - SCORING: Journal article

C2 - 24862392

VL - 83

SP - 1285

EP - 1291

JO - UROLOGY

JF - UROLOGY

SN - 0090-4295

IS - 6

ER -