title: Local tumor destruction in renal cell carcinoma--an inpatient population-based study.
abstract: OBJECTIVE
  Local tumor destruction (LTD) is a recommended therapy alternative for localized T1 renal cell carcinoma for patients who are unfit for surgery. We examined patterns of use and complication rates of LTD in a large population-based cohort.
  
  
  METHODS
  Overall, data for 5,285 patients undergoing LTD for renal cell carcinoma were extracted from the Nationwide Inpatient Sample database from 2006 to 2010. We assessed patient and hospital characteristics, as well as postoperative complications, using International Classification of Diseases, Ninth Revision codes. The effect of patient and hospital characteristics on peri-interventional complications (overall or specific) was tested using univariable or multivariable logistic regression models.
  
  
  RESULTS
  Most patients were male (61.2%), aged 71 to 80 years (34.9%), and had 3 or more comorbidities (30.6%). Most LTDs were performed at urban (93.5%), teaching (57.7%), and low-volume (75.7%) hospitals. Overall complications were recorded in 15.4% of patients. In multivariable analyses adjusted for clustering, overall complications occurred more frequently in older, sicker patients who were treated at low-volume hospitals (all P<0.05). Similar results were recorded when each complication category was addressed individually.
  
  
  CONCLUSIONS
  In the current population-based cohort, complications of LTD occurred in 1 of 6 patients and were more frequent in individuals with advanced age or multiple comorbidities, or both, especially if LTDs were performed at lower-volume hospitals.
authors.affiliation: Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Centre, Montreal, Canada. Electronic address: vincent.trudeau.1@umontreal.ca.
authors.forename: Vincent
authors.initials: V
authors.lastname: Trudeau
authors.affiliation: Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Centre, Montreal, Canada; Martini-Clinic, Prostate Cancer Center Hamburg-Eppendorf, Hamburg, Germany.
authors.forename: Andreas
authors.initials: A
authors.lastname: Becker
authors.affiliation: Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Centre, Montreal, Canada; Department of Urology, Ruhr University Bochum, Marienhospital, Herne, Germany.
authors.forename: Florian
authors.initials: F
authors.lastname: Roghmann
authors.affiliation: Department of Urology, Medical University of Vienna, Vienna, Austria.
authors.forename: Shahrokh F
authors.initials: SF
authors.lastname: Shariat
authors.affiliation: Department of Urology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
authors.forename: Luis Alex
authors.initials: LA
authors.lastname: Kluth
authors.affiliation: Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Centre, Montreal, Canada.
authors.forename: Nawar
authors.initials: N
authors.lastname: Hanna
authors.affiliation: Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Centre, Montreal, Canada.
authors.forename: Al'a
authors.initials: A
authors.lastname: Abdo
authors.affiliation: Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Centre, Montreal, Canada; Department of Urology, Vita-Salute, San Raffaele University, Milan, Italy.
authors.forename: Giorgio
authors.initials: G
authors.lastname: Gandaglia
authors.affiliation: Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Centre, Montreal, Canada.
authors.forename: Zhe
authors.initials: Z
authors.lastname: Tian
authors.affiliation: Department of Urology, University of Montreal Health Centre, Montreal, Canada.
authors.forename: Paul
authors.initials: P
authors.lastname: Perrotte
authors.affiliation: Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Centre, Montreal, Canada; Department of Urology, University of Montreal Health Centre, Montreal, Canada.
authors.forename: Quoc-Dien
authors.initials: QD
authors.lastname: Trinh
authors.affiliation: Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Centre, Montreal, Canada; Department of Urology, University of Montreal Health Centre, Montreal, Canada.
authors.forename: Pierre I
authors.initials: PI
authors.lastname: Karakiewicz
authors.affiliation: Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Centre, Montreal, Canada.
authors.forename: Maxine
authors.initials: M
authors.lastname: Sun
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002292:Carcinoma, Renal Cell / Q000628:therapy*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007297:Inpatients / Q000706:statistics & numerical data*; D007680:Kidney Neoplasms / Q000628:therapy*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D017063:Outcome Assessment, Health Care / Q000706:statistics & numerical data*
keywords: Ablation; Carcinoma; Complications; Kidney; Nationwide inpatient sample; Renal cell