title: Complications After Metastasectomy for Renal Cell Carcinoma-A Population-based Assessment.
abstract: Metastasectomy has long been considered a valid treatment option for patients with oligometastatic renal cell carcinoma (oligo-mRCC). However, the literature on complications in this setting is scarce. Our objective was to describe in-hospital complications after metastasectomy in a contemporary cohort of patients with mRCC. Using the National Inpatient Sample database (2000-2011), 45 279 mRCC patients were identified. Of those, 1102 underwent metastasectomies. The metastatic sites were the lungs, bone, liver, lymph nodes, adrenal glands, and brain in, respectively, 52%, 29%, 19%, 14%, 11%, and 3.4% of patients. The overall complication rate was 45.7%. Major complications (Clavien III-V) constituted 27.5%. Resections of hepatic lesions were significantly associated with higher odds of overall complications compared with any other site (odds ratio 2.59, 95% confidence interval 1.84-3.62, p<0.001). While metastasectomy remains a potential treatment option in RCC with oligometastatic disease, the associated complication rates are non-negligible; therefore, careful patient selection is warranted.
  
  
  
  We studied outcomes of patients with metastatic kidney cancer treated with metastasectomy. While metastasectomy is a treatment option for metastatic renal cell carcinoma, complications are not insignificant and our results may guide preoperative counseling.
authors.affiliation: Center for Surgery and Public Health, Division of Urologic Surgery, Brigham and Women's Hospital, Boston, Massachusetts, USA; Department of Urology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
authors.forename: Christian P
authors.initials: CP
authors.lastname: Meyer
authors.affiliation: Center for Surgery and Public Health, Division of Urologic Surgery, Brigham and Women's Hospital, Boston, Massachusetts, USA.
authors.forename: Maxine
authors.initials: M
authors.lastname: Sun
authors.affiliation: Department of Urology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
authors.forename: Jose A
authors.initials: JA
authors.lastname: Karam
authors.affiliation: Center for Surgery and Public Health, Division of Urologic Surgery, Brigham and Women's Hospital, Boston, Massachusetts, USA.
authors.forename: Jeffrey J
authors.initials: JJ
authors.lastname: Leow
authors.affiliation: Department of Medical Oncology, Lank Center for Genitourinary Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA; Department of Medical Oncology, University Hospital 12 de Octubre, Madrid, Spain.
authors.forename: Guillermo
authors.initials: G
authors.lastname: de Velasco
authors.affiliation: Department of Medical Oncology & Therapeutics Research, City of Hope, Duarte, California, USA.
authors.forename: Sumanta K
authors.initials: SK
authors.lastname: Pal
authors.affiliation: Center for Surgery and Public Health, Division of Urologic Surgery, Brigham and Women's Hospital, Boston, Massachusetts, USA.
authors.forename: Steven L
authors.initials: SL
authors.lastname: Chang
authors.affiliation: Center for Surgery and Public Health, Division of Urologic Surgery, Brigham and Women's Hospital, Boston, Massachusetts, USA.
authors.forename: Quoc-Dien
authors.initials: QD
authors.lastname: Trinh
authors.affiliation: Department of Medical Oncology, Lank Center for Genitourinary Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA. Electronic address: Toni_Choueiri@DFCI.HARVARD.EDU.
authors.forename: Toni K
authors.initials: TK
authors.lastname: Choueiri
mesh_terms: D002292:Carcinoma, Renal Cell / Q000401:mortality / Q000556:secondary* / Q000601:surgery*; D000066491:Clinical Decision-Making; D016208:Databases, Factual; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007680:Kidney Neoplasms / Q000401:mortality / Q000473:pathology*; D016015:Logistic Models; D008297:Male; D059146:Metastasectomy / Q000009:adverse effects* / Q000401:mortality; D016017:Odds Ratio; D018579:Patient Selection; D011183:Postoperative Complications / Q000209:etiology* / Q000401:mortality; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D014481:United States
keywords: Clavien–Dindo; Complication; Metastasectomy; Renal cell carcinoma