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dc.contributor.authorThoroddsen, Asgeir
dc.contributor.authorGudbjartsson, Tomas
dc.contributor.authorJonsson, Eirikur
dc.contributor.authorGislason, Thorsteinn
dc.contributor.authorEinarsson, Gudmundur Vikar
dc.date.accessioned2006-09-27T11:21:24Z
dc.date.available2006-09-27T11:21:24Z
dc.date.issued2003
dc.identifier.citationScand J Urol Nephrol 2003, 37(6):507-11en
dc.identifier.issn0036-5599
dc.identifier.pmid14675926
dc.identifier.doi10.1080/00365590310015732
dc.identifier.otherURO12
dc.identifier.urihttp://hdl.handle.net/2336/4641
dc.descriptionTo access publisher full text version of this article. Please click on the hyperlink in Additional Links fielden
dc.description.abstractOBJECTIVE: To study the rate and causes of operative and treatment-related mortality after nephrectomy for renal cell carcinoma (RCC) in Iceland. MATERIAL AND METHODS: This retrospective population-based study included all patients who underwent nephrectomy for RCC in Iceland between 1971 and 2000. Patients who died <30 days after the operation were analyzed and compared to those who survived surgery. Disease stage, tumor size, patient age and preoperative American Society of Anesthesiologists classification were compared between the two groups. Autopsy records were examined to determine the causes of death. RESULTS: During the study period 880 patients were diagnosed with RCC and 575 (65%) of them underwent a nephrectomy, 116 (20%) with palliative intent. Operative mortality (OM) was 2.8% and did not change during the 30-year period. Patients with OM were significantly older than those without (73 vs 64 years, respectively) but disease stage, tumor size, ASA classification and gender were comparable between the groups. OM was comparable for patients operated on with palliative (3.4%) vs. curative (2.6%) intent (ns). Median time of death was 10 days postoperatively but no patient died intraoperatively. Causes of death were peri- and postoperative bleeding in five patients, infection/sepsis in four, arrhythmia in three, acute renal failure in two, pulmonary embolism in one and multiorgan failure in one. CONCLUSIONS: OM after nephrectomy for RCC has remained low during the past three decades in Iceland. It is most often caused by perioperative bleeding and infections. We find that the low OM in patients with metastases gives support to the use of palliative nephrectomy as a treatment option when other forms of treatment have failed.
dc.language.isoenen
dc.publisherTaylor & Francisen
dc.relation.urlhttp://search.ebscohost.com/login.aspx?direct=true&db=aph&AN=11692363&site=ehost-liveen
dc.subject.meshSurvival Rateen
dc.subject.meshStatistics, Nonparametricen
dc.subject.meshSex Distributionen
dc.subject.meshRisk Assessmenten
dc.subject.meshResearch Support, Non-U.S. Gov'ten
dc.subject.meshProbabilityen
dc.subject.meshNephrectomyen
dc.subject.meshNeoplasm Stagingen
dc.subject.meshMiddle Ageden
dc.subject.meshMaleen
dc.subject.meshKidney Neoplasmsen
dc.subject.meshIcelanden
dc.subject.meshHospital Mortalityen
dc.subject.meshCarcinoma, Renal Cellen
dc.subject.meshAge Distributionen
dc.titleOperative mortality after nephrectomy for renal cell carcinomaen
dc.typeArticleen
dc.format.digYES
html.description.abstractOBJECTIVE: To study the rate and causes of operative and treatment-related mortality after nephrectomy for renal cell carcinoma (RCC) in Iceland. MATERIAL AND METHODS: This retrospective population-based study included all patients who underwent nephrectomy for RCC in Iceland between 1971 and 2000. Patients who died <30 days after the operation were analyzed and compared to those who survived surgery. Disease stage, tumor size, patient age and preoperative American Society of Anesthesiologists classification were compared between the two groups. Autopsy records were examined to determine the causes of death. RESULTS: During the study period 880 patients were diagnosed with RCC and 575 (65%) of them underwent a nephrectomy, 116 (20%) with palliative intent. Operative mortality (OM) was 2.8% and did not change during the 30-year period. Patients with OM were significantly older than those without (73 vs 64 years, respectively) but disease stage, tumor size, ASA classification and gender were comparable between the groups. OM was comparable for patients operated on with palliative (3.4%) vs. curative (2.6%) intent (ns). Median time of death was 10 days postoperatively but no patient died intraoperatively. Causes of death were peri- and postoperative bleeding in five patients, infection/sepsis in four, arrhythmia in three, acute renal failure in two, pulmonary embolism in one and multiorgan failure in one. CONCLUSIONS: OM after nephrectomy for RCC has remained low during the past three decades in Iceland. It is most often caused by perioperative bleeding and infections. We find that the low OM in patients with metastases gives support to the use of palliative nephrectomy as a treatment option when other forms of treatment have failed.


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