Daniel B Kim1, Richard Gray2, Zhuo Li3, Nabil Wasif2, Sanjay P Bagaria1. 1. Department of Surgery, Mayo Clinic, Jacksonville, Florida. 2. Department of Surgery, Mayo Clinic, Scottsdale, Arizona. 3. Department of Health Sciences Research, Mayo Clinic, Jacksonville, Florida.
Abstract
BACKGROUND AND OBJECTIVES: Surgical resection of retroperitoneal sarcomas (RPS) often involves removal of the ipsilateral kidney. We evaluated the long-term post-operative renal function in patients who underwent a nephrectomy as part of their en-bloc resection of RPS. METHODS: Retrospective review of an institutional database identified RPS patients who underwent nephrectomy for curative intent from 1990 to 2014. The primary outcome measured was chronic kidney disease (CKD) calculated by the glomerular filtration rate (GFR). RESULTS: Of the 47 patients in our study, 19 (40%), 18 (38%), and 10 (21%) patients had a preoperative CKD stage 1, 2, and 3, respectively. The GFR decreased by an average of 33.4 mL/min/1.73 m2 with 66% of patients demonstrating mild progression of their renal impairment. Only three (6%) patients progressed to CKD stage 4 or 5, one of which required life-long dialysis. CONCLUSION: Nephrectomy as part of an en-bloc resection is associated with a decrease in GFR that is not clinically significant. Fear of kidney failure should not prevent a surgeon from performing a nephrectomy in the treatment of RPS.
BACKGROUND AND OBJECTIVES: Surgical resection of retroperitoneal sarcomas (RPS) often involves removal of the ipsilateral kidney. We evaluated the long-term post-operative renal function in patients who underwent a nephrectomy as part of their en-bloc resection of RPS. METHODS: Retrospective review of an institutional database identified RPS patients who underwent nephrectomy for curative intent from 1990 to 2014. The primary outcome measured was chronic kidney disease (CKD) calculated by the glomerular filtration rate (GFR). RESULTS: Of the 47 patients in our study, 19 (40%), 18 (38%), and 10 (21%) patients had a preoperative CKD stage 1, 2, and 3, respectively. The GFR decreased by an average of 33.4 mL/min/1.73 m2 with 66% of patients demonstrating mild progression of their renal impairment. Only three (6%) patients progressed to CKD stage 4 or 5, one of which required life-long dialysis. CONCLUSION: Nephrectomy as part of an en-bloc resection is associated with a decrease in GFR that is not clinically significant. Fear of kidney failure should not prevent a surgeon from performing a nephrectomy in the treatment of RPS.
Authors: William W Tseng; Carol J Swallow; Dirk C Strauss; Sylvie Bonvalot; Piotr Rutkowski; Samuel J Ford; Ricardo J Gonzalez; Rebecca A Gladdy; David E Gyorki; Mark Fairweather; Kyo Won Lee; Markus Albertsmeier; Winan J van Houdt; Magalie Fau; Carolyn Nessim; Giovanni Grignani; Kenneth Cardona; Vittorio Quagliuolo; Valerie Grignol; Jeffrey M Farma; Elisabetta Pennacchioli; Marco Fiore; Andrew Hayes; Dimitri Tzanis; Jacek Skoczylas; Max L Almond; John E Mullinax; Wendy Johnston; Hayden Snow; Rick L Haas; Dario Callegaro; Myles J Smith; Toufik Bouhadiba; Anant Desai; Rachel Voss; Roberta Sanfilippo; Robin L Jones; Elizabeth H Baldini; Andrew J Wagner; Charles N Catton; Silvia Stacchiotti; Khin Thway; Christina L Roland; Chandrajit P Raut; Alessandro Gronchi Journal: Ann Surg Oncol Date: 2022-06-29 Impact factor: 4.339
Authors: Carol J Swallow; Dirk C Strauss; Sylvie Bonvalot; Piotr Rutkowski; Anant Desai; Rebecca A Gladdy; Ricardo Gonzalez; David E Gyorki; Mark Fairweather; Winan J van Houdt; Eberhard Stoeckle; Jae Berm Park; Markus Albertsmeier; Carolyn Nessim; Kenneth Cardona; Marco Fiore; Andrew Hayes; Dimitri Tzanis; Jacek Skoczylas; Samuel J Ford; Deanna Ng; John E Mullinax; Hayden Snow; Rick L Haas; Dario Callegaro; Myles J Smith; Toufik Bouhadiba; Silvia Stacchiotti; Robin L Jones; Thomas DeLaney; Christina L Roland; Chandrajit P Raut; Alessandro Gronchi Journal: Ann Surg Oncol Date: 2021-04-14 Impact factor: 4.339
Authors: Christopher C Stahl; Patrick B Schwartz; Cecilia G Ethun; Nicholas Marka; Bradley A Krasnick; Thuy B Tran; George A Poultsides; Kevin K Roggin; Ryan C Fields; Callisia N Clarke; Konstantinos I Votanopoulos; Kenneth Cardona; Daniel E Abbott Journal: Ann Surg Oncol Date: 2020-11-04 Impact factor: 5.344