Comparison of costs and complications of radical and partial nephrectomy for treatment of localized renal cell carcinoma.
OBJECTIVE
To compare the complications and costs of radical and partial nephrectomy (PN) and to investigate the impact of increasing experience on costs and complications during a 7-year period. Nephron-sparing surgery has found increasing applications in the past decade. PN has achieved similar long-term results in localized renal cell carcinoma with respect to cancer control compared with radical nephrectomy (RN). However, data are limited on the direct comparison of complications and hospital costs between these two modalities.


METHODS
A retrospective case-matched study was performed comparing 60 RNs and 60 PNs during a 7-year period with respect to complications and hospital costs. A longitudinal comparison was also performed between the various periods to assess the impact of surgical experience on these parameters.


RESULTS
The mean length of stay was 6.4 +/- 3 days in the RN group and 6.4 +/- 3.3 days in the PN group. The hospital costs were comparable between the two procedures during the observed interval. The mean operative time was 176.6 +/- 51.6 minutes for RN and 220.1 +/- 59.6 minutes for PN (P = 0.0001). This difference was accentuated during the observed period. No differences were found in the blood loss and transfusion rates between the groups. The complication rate was 3.3% and 10% for RN and PN, respectively (P = 0.2).


CONCLUSIONS
Our data suggest that RN and PN can be performed with a similar rate of complications and comparable hospital costs. This is of practical importance when comparing these modalities as treatment options for localized renal cell carcinoma.
Shekarriz
Bijan
B
Department of Urology, Wayne State University and Barbara Ann Karmanos Cancer Institute, Detroit, Michigan 48201, USA.
Upadhyay
Jyoti
J
Shekarriz
Hodjat
H
de Assis Mendes Goes
Francisco
F
Bianco
Fernando J
FJ
Tiguert
Rabi
R
Gheiler
E
E
Wood
David P
DP
Aziz
Goes
G
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016063:Blood Loss, Surgical; D002173:Cancer Care Facilities / Q000191:economics* / Q000706:statistics & numerical data; D002292:Carcinoma, Renal Cell / Q000473:pathology / Q000601:surgery*; D016022:Case-Control Studies; D017721:Hospital Costs / Q000706:statistics & numerical data*; D006801:Humans; D007680:Kidney Neoplasms / Q000473:pathology / Q000601:surgery*; D007902:Length of Stay; D008824:Michigan / Q000453:epidemiology; D008875:Middle Aged; D009392:Nephrectomy / Q000009:adverse effects / Q000191:economics* / Q000379:methods; D011183:Postoperative Complications / Q000453:epidemiology; D012189:Retrospective Studies