Renal Function After Retroperitoneal Sarcoma Resection with Nephrectomy: A Matched Analysis of the United States Sarcoma Collaborative Database

BACKGROUND: Nephrectomy is often required during en bloc resection of a retroperitoneal sarcoma (RPS) to achieve an R0/R1 resection. The impact of nephrectomy on postoperative renal function in this patient population, who may also benefit from subsequent nephrotoxic systemic therapy, is not well described. METHODS: The United States Sarcoma Collaborative (USSC) database was queried for patients undergoing RPS resection between 2000–2016. Patients missing pre- or postoperative measures of renal function were excluded. A matched cohort was created using coarsened exact matching. Weighted logistic regression was used to further control for differences in the nephrectomy vs non-nephrectomy cohorts. Primary outcomes included postoperative acute kidney injury (AKI), acute renal failure (ARF), and dialysis. RESULTS: The initial cohort consisted of 858 patients, of which 3 patients (0.3%) required postoperative dialysis. The matched cohort consisted of 411 patients of which 108 patients (26%) underwent nephrectomy. Patients that underwent nephrectomy had higher rates of postoperative AKI (14.8% vs 4.3%, p