Cardiopulmonary Events: Study Finds Small but Real Risk After Partial Nephrectomy
Posted: Tuesday, October 12, 2021
When discussing a decision about surgery versus active surveillance with a patient who has low-risk kidney cancer, when the latter is an oncologically safe option, it’s sensible to mention the rare but possible postoperative cardiopulmonary events, according to Kevin Ginsburg, MD, of Fox Chase Cancer Center in Philadelphia, and colleagues. This suggestion is based on the results of their recent work, which were presented during the 2021 American Urological Association (AUA) Annual Meeting (Abstract MP19-16) and published in The Journal of Urology.
“If we think about it, the perioperative risks of surgery are immediate and around 2%,” stated Dr. Ginsburg in a Fox Chase press release. “The oncological risks with not treating someone with surgery are typically delayed to 5 or 10 years down the line, which is a similar risk of around 2% or 3% of dying from a cancer like this.”
The team’s focus was on patients with newly diagnosed low-risk renal and prostate cancers. Specifically, the data were from almost 65,000 patients who underwent partial nephrectomy (about 28%) and minimally invasive prostatectomy (about 72%) between 2015 and 2019.
The cardiopulmonary events included in the analysis were pneumonia, deep vein thrombosis, pulmonary embolism, stroke, myocardial infarction, cardiovascular arrest, and death. Of the 64,975 patients whose data the authors gleaned from the American College of Surgeons National Surgical Quality Improvement Program database, 1,160 patients (1.8%) had a cardiopulmonary event, and 87 died within 30 days of the index surgery. Additionally, within those 30 days, 2,876 patients (4.4%) were readmitted, and 872 (1.3%) underwent reoperation. Not surprisingly, those patients with postoperative cardiopulmonary events were significantly more likely than those without to be readmitted (44.7% vs. 3.7%; P < .001), undergo reoperation (10.3% vs. 1.2%; P < .001), and have a longer postoperative stay (2 days vs. 1 day; P < .001).
Disclosure: The study authors reported no conflicts of interest.