BACKGROUND: Nephrectomy often is required during en bloc resection of a retroperitoneal sarcoma (RPS) to achieve an R0 or R1 resection. The impact of nephrectomy on postoperative renal function in this patient population, who also may benefit from subsequent nephrotoxic systemic therapy, is not well described. METHODS: The United States Sarcoma Collaborative (USSC) database was queried for patients undergoing RPS resection between 2000 and 2016. Patients with missing pre- or postoperative measures of renal function were excluded. A matched cohort was created using coarsened exact matching. Weighted logistic regression was used to control further for differences between the nephrectomy and non-nephrectomy cohorts. The primary outcomes were postoperative acute kidney injury (AKI), acute renal failure (ARF), and dialysis. RESULTS: The initial cohort consisted of 858 patients, 3 (0.3%) of whom required postoperative dialysis. The matched cohort consisted of 411 patients, 108 (26%) of whom underwent nephrectomy. The patients who underwent nephrectomy had higher rates of postoperative AKI (14.8% vs 4.3%; p < 0.01) and ARF (4.6% vs 1.3%; p = 0.04), but no patients required dialysis postoperatively. Logistic regression modeling showed that the risk of AKI (odds ratio [OR], 5.16; p < 0.01) and ARF (OR 5.04; p < 0.01) after nephrectomy persisted despite controlling for age and preoperative renal function. CONCLUSIONS: Nephrectomy is associated with an increased risk of postoperative AKI and ARF after RPS resection. This study was unable to statistically assess the impact of nephrectomy on postoperative dialysis, but the risk of postoperative dialysis is 0.5% or less regardless of nephrectomy status.
BACKGROUND: Nephrectomy often is required during en bloc resection of a retroperitoneal sarcoma (RPS) to achieve an R0 or R1 resection. The impact of nephrectomy on postoperative renal function in this patient population, who also may benefit from subsequent nephrotoxic systemic therapy, is not well described. METHODS: The United States Sarcoma Collaborative (USSC) database was queried for patients undergoing RPS resection between 2000 and 2016. Patients with missing pre- or postoperative measures of renal function were excluded. A matched cohort was created using coarsened exact matching. Weighted logistic regression was used to control further for differences between the nephrectomy and non-nephrectomy cohorts. The primary outcomes were postoperative acute kidney injury (AKI), acute renal failure (ARF), and dialysis. RESULTS: The initial cohort consisted of 858 patients, 3 (0.3%) of whom required postoperative dialysis. The matched cohort consisted of 411 patients, 108 (26%) of whom underwent nephrectomy. The patients who underwent nephrectomy had higher rates of postoperative AKI (14.8% vs 4.3%; p < 0.01) and ARF (4.6% vs 1.3%; p = 0.04), but no patients required dialysis postoperatively. Logistic regression modeling showed that the risk of AKI (odds ratio [OR], 5.16; p < 0.01) and ARF (OR 5.04; p < 0.01) after nephrectomy persisted despite controlling for age and preoperative renal function. CONCLUSIONS: Nephrectomy is associated with an increased risk of postoperative AKI and ARF after RPS resection. This study was unable to statistically assess the impact of nephrectomy on postoperative dialysis, but the risk of postoperative dialysis is 0.5% or less regardless of nephrectomy status.
Authors: D Callegaro; R Miceli; C Brunelli; C Colombo; R Sanfilippo; S Radaelli; P G Casali; A Caraceni; A Gronchi; M Fiore Journal: Br J Surg Date: 2015-06-03 Impact factor: 6.939
Authors: Warren H Tseng; Steve R Martinez; Robert M Tamurian; Steven L Chen; Richard J Bold; Robert J Canter Journal: J Surg Oncol Date: 2010-12-28 Impact factor: 3.454
Authors: Sean J Judge; Kathleen Lata-Arias; Mio Yanagisawa; Morgan A Darrow; Arta M Monjazeb; Amanda R Kirane; Richard J Bold; Robert J Canter; Daniel J Canter Journal: J Surg Oncol Date: 2019-07-29 Impact factor: 3.454
Authors: Andrea J MacNeill; Alessandro Gronchi; Rosalba Miceli; Sylvie Bonvalot; Carol J Swallow; Peter Hohenberger; Frits Van Coevorden; Piotr Rutkowski; Dario Callegaro; Andrew J Hayes; Charles Honoré; Mark Fairweather; Amanda Cannell; Jens Jakob; Rick L Haas; Milena Szacht; Marco Fiore; Paolo G Casali; Raphael E Pollock; Francesco Barretta; Chandrajit P Raut; Dirk C Strauss Journal: Ann Surg Date: 2018-05 Impact factor: 12.969
Authors: Abimereki D Muzaale; Allan B Massie; Mei-Cheng Wang; Robert A Montgomery; Maureen A McBride; Jennifer L Wainright; Dorry L Segev Journal: JAMA Date: 2014-02-12 Impact factor: 56.272
Authors: Fernando B Rodrigues; Rosana G Bruetto; Ulysses S Torres; Ana P Otaviano; Dirce M T Zanetta; Emmanuel A Burdmann Journal: PLoS One Date: 2013-07-23 Impact factor: 3.240
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: Patrick B Schwartz; Christopher C Stahl; Roberto J Vidri; Glen E Leverson; Yana Puckett; Syed N Zafar; Patrick Varley; Sean M Ronnekleiv-Kelly; Ahmed Al-Niaimi; Sharon M Weber; Daniel E Abbott Journal: Ann Surg Oncol Date: 2022-06-07 Impact factor: 4.339
Authors: Xiaobing Chen; Jun Chen; Ferdinando Carlo Maria Cananzi; Wenjie Li; Vittorio Quagliuolo; Chenghua Luo; Yinmo Yang Journal: Technol Cancer Res Treat Date: 2022 Jan-Dec