Introduction

Metastasectomy (MSx) is a viable option in patients with metastatic renal cell carcinoma (mRCC). Available information on perioperative outcomes is scarce. We assess complications of MSx in a large population-based US cohort.

Methods

The Nationwide Inpatient Sample (2000-2011) was utilized to abstract all patients with a primary diagnosis of mRCC. MSx was defined as an organ-specific resection as a diagnosis of a metastasis to a corresponding site (liver; lung; brain; bones; lymph nodes; adrenal) during the same admission. All procedures concomitantly performed with radical or partial nephrectomies were excluded. Baseline characteristics and multivariable logistic regression analyzes described in-hospital complications, length of stay, and mortality following MSx.

Results

Overall, 26990 weighted patients had mRCC. Of those, 949 were treated with a MSx (3.5%). Common sites of MSx were liver (47.8%) and lung (33.2%). MSx patients were significantly younger than non-MSx patients (60 vs. 62 years, p=0.013). Overall in-hospital mortality rate was 2%. The most common in-hospital complications were prolonged length of stay, defined as ?7 days (38.5%), respiratory complications (17.1%), vascular complications (14.8%), and blood transfusions (16.3%). In multivariable analyses neither patient nor hospital characteristics were significant predictors of overall complication rates.

Conclusions

This study suggests that MSx is a sensible and safe approach for the treatment of mRCC. We did not find significant predictors of complications for MSx in mRCC patients. Nevertheless, postoperative care should be optimized to prevent unnecessary complications and prolonged length of stay.

Funding

none