Impact Factors of the Nephrectomy Outcomes

Abstract

Renal cell carcinoma (RCC) represents approximately 3% of all cancers with a high incidence, especially in western countries. There has been an increasing annual trend during the last two decades. For the localized RCC (T1-2N0M0), partial nephrectomy (PN) and radical nephrectomy (RN) are the most common surgical management. There are various factors associated with surgical complications, which play an essential role in making treatment strategies. To better understand the factors that impact the morbidity of kidney surgery for renal masses and kidney cancer, we analyze an extensive administrative database to understand better the questions we encountered in the clinic. Surgical outcomes are influenced by a complex interplay of factors, some more obvious than others. Marital status, which is one of the most overlooked areas for clinicians in particular, has been shown to have a substantial protective effect on survival and event-free rate in relative cancer survival for certain less-lethal cancers and specific postoperative patients. However, whether marital status offers this clinical benefit, specifically during kidney cancer surgery, remains unknown. Antithrombic drugs are commonly used to prevent thromboembolic events such as myocardial infarction and stroke, But In addition to the therapeutic effect, antithrombotic drugs will increase bleeding risk. Widely held belief that antithrombotic drugs for those who underwent surgery will increase the bleeding risk. In some cases, surgeons do not have the choice to stop the AP/AC drugs, especially for those who have a high risk of the acute coronary syndrome (ACS) or stroke. Whether perioperative oral antithrombotic drug use could increase bleeding complications in partial nephrectomy is controversial. To answer the two questions above, we used a large, nationally representative database to analyze the association between the predictors and surgical outcomes in nephrectomy patients.