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Venous Thromboembolism at the Time of Surgery for a Renal Mass: Clinical Implications

By: Julia Fiederlein
Posted: Wednesday, February 10, 2021

The presence of venous thromboembolism at the time of surgery for a renal mass suspected of being renal cell carcinoma seems to be associated with increased rates of major complications, mortality, and higher overall costs, according to Hiren V. Patel, MD, PhD, of Rutgers Cancer Institute of New Jersey and Rutgers Robert Wood Johnson Medical School, New Brunswick, and colleagues. This analysis presented during the virtual edition of the 2020 Society of Urologic Oncology (SUO) Annual Meeting (Abstract 79) may assist in counseling and managing these patients.

“Recent studies have demonstrated that the presence of bland inferior vena cava or renal vein thrombus at the time of renal cell carcinoma surgery is associated with worse outcomes,” the investigators commented. “However, the impact of venous thromboembolism at [the] time of renal cell carcinoma surgery remains to be understood, particularly among patients without an inferior vena cava or renal vein thrombus.”

In this study, the investigators focused on data from the Premier Healthcare database on 122,342 patients who underwent elective surgical resection for a renal mass between 2013 and 2017. A total of 83,692 and 38,650 patients underwent radical and partial nephrectomies, respectively.

Patients with venous thromboembolism seemed to have a significantly higher predicted probability of mortality (radical: 2.6% vs. 1.0%; partial: 1.3% vs. 0.3%; P < .001), nonfatal minor complications (radical: 34.2% vs. 21.1%; partial: 36.9% vs. 22.5%; P < .001), and nonfatal major complications (radical: 10.6% vs. 5.2%; partial: 21.5% vs. 5.0%; P < .001) than those without. Additionally, the 90-day median costs of care were higher for patients with venous thromboembolism than for those without (radial: $24,648 vs. $13,951; partial: $19,338 vs. $13,694; P < .001).

Disclosure: No information regarding conflicts of interest was provided.

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