Background:

Current evidence shows that cytoreductive nephrectomy (CN) could offer a survival benefit for patients with metastatic renal cell carcinoma (RCC). Nevertheless, due to a higher risk of perioperative complications this therapeutic strategy should be evaluated thoroughly. To identify perioperative mortality and morbidity predictors associated to CN, we analyzed metastatic RCC patients treated with surgery in our Institution.

Patients and methods:

We evaluated those patients with metastatic RCC treated with CN between 1980-2016 at our Institution. Univariate and binomial logistic regression analysis was used to assess predictors of adverse outcomes within a 30-day postoperative period. We defined a p value < 0.05 as statistically significant.

Results:

46 patients with clinical stage IV RCC were included in this analysis; 32.6% had perioperative morbidity. Clavien-Dindo grade ≥ III complications occurred in 17.4%. Perioperative mortality was 15.2%. In multivariate analysis, age ≥ 65 years was an independent predictor of perioperative morbidity (p = 0.001). No factors were associated with perioperative mortality.

Conclusions:

Patients ≥ 65 years old with metastatic RCC, nephrectomy has a higher risk of complications and perioperative mortality. Therefore, the benefit of surgical therapy in this population should be evaluated thoroughly.

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