Zurück zur Übersicht
| The Journal of urology. 2015 Mar 19. doi: 10.1016/j.juro.2015.02.2948. pmc: PMC5012645. mid: NIHMS805073 |
| Cardiopulmonary Bypass has No Significant Impact on Survival in Patients Undergoing Nephrectomy and Level III-IV Inferior Vena Cava Thrombectomy: Multi-Institutional Analysis. |
| Nguyen HG1, Tilki D2, Dall'Era MA3, Durbin-Johnson B4, Carballido JA5, Chandrasekar T6, Chromecki T7, Ciancio G8, Daneshmand S9, Gontero P10, Gonzalez J11, Haferkamp A12, Hohenfellner M13, Huang WC14, Espinós EL15, Mandel P16, Martinez-Salamanca JI17, Master VA18, McKiernan JM19, Montorsi F20, Novara G21, Pahernik S22, Palou J23, Pruthi RS24, Rodriguez-Faba O25, Russo P26, Scherr DS27, Shariat SF28, Spahn M29, Terrone C30, Vergho D31, Wallen EM32, Xylinas E33, Zigeuner R34, Libertino JA35, Evans CP36 |
 Author information
|
|
Abstract PURPOSE: The impact of cardiopulmonary bypass in level III-IV tumor thrombectomy on surgical and oncologic outcomes is unknown. We determine the impact of cardiopulmonary bypass on overall and cancer specific survival, as well as surgical complication rates and immediate outcomes in patients undergoing nephrectomy and level III-IV tumor thrombectomy with or without cardiopulmonary bypass. MATERIALS AND METHODS: We retrospectively analyzed 362 patients with renal cell cancer and with level III or IV tumor thrombus from 1992 to 2012 at 22 U.S. and European centers. Cox proportional hazards models were used to compare overall and cancer specific survival between patients with and without cardiopulmonary bypass. Perioperative mortality and complication rates were assessed using logistic regression analyses. RESULTS: Median overall survival was 24.6 months in noncardiopulmonary bypass cases and 26.6 months in cardiopulmonary bypass cases. Overall survival and cancer specific survival did not differ significantly in both groups on univariate analysis or when adjusting for known risk factors. On multivariate analysis no significant differences were seen in hospital length of stay, Clavien 1-4 complication rate, intraoperative or 30-day mortality and cancer specific survival. Limitations include the retrospective nature of the study. CONCLUSIONS: In our multi-institutional analysis the use of cardiopulmonary bypass did not significantly impact cancer specific survival or overall survival in patients undergoing nephrectomy and level III or IV tumor thrombectomy. Neither approach was independently associated with increased mortality on multivariate analysis. Greater surgical complications were not independently associated with the use of cardiopulmonary bypass. |
|
Copyright © 2015 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved. |
|
KEYWORDS: carcinoma, cardiopulmonary bypass, inferior, intraoperative complications, renal cell, survival, vena cava |
|
Publikations ID: 25797392 Quelle: öffnen |
Author information
Schnellinfo
-- Cancer Care
-- Kliniken und Partner
-- CCC Cancer School
-- Young CCC
-- CCC Tumorboards
-- CCC Forschungscluster
-- CCC Units
-- CCC Platforms
-- SOPs / Leitlinien
-- Kontakt
Featured
