Back to Search Start Over

Complications associated with perioperative use of tyrosine kinase inhibitor in cytoreductive nephrectomy

Authors :
Keith J. Kowalczyk
Filipe L F Carvalho
Kenneth Witmer
John O’Neill
John H. Lynch
Chaoyi Zheng
Source :
Scientific Reports, Vol 9, Iss 1, Pp 1-5 (2019), Scientific Reports
Publication Year :
2019
Publisher :
Nature Publishing Group, 2019.

Abstract

Recent clinical trials have investigated the benefit of combining tyrosine kinase inhibitors (TKIs) and cytoreductive nephrectomy (CN) in patients with metastatic renal cell carcinoma. Our goal is to determine whether the perioperative use of TKIs increases the postoperative morbidity following CN in renal cell carcinoma patients. We identified 627 patients with Stage IV renal cell carcinoma who underwent CN from 2007–2010 utilizing the SEER-Medicare database. Eighty-two patients treated with TKIs were matched (3:1) to 246 controls. We calculated 30- and 90-day incidence rates of postoperative complications and mortality. On unadjusted analysis, TKI use prior to CN was associated with higher overall complication rate within 30 days (HR = 2.73, 95% CI: 1.09–6.8) after surgery. On multivariate analysis, perioperative TKI use was independently associated with higher risk for postoperative complications within 30 days (HR = 2.93, 95% CI: 1.17–7.36), as well as 90 days (HR = 1.84, 95% CI: 1.02–3.32) after nephrectomy. A higher Charlson comorbidity index also emerged to represent an independent risk factor for postoperative complications within 30 days (HR = 2.41, 95% CI: 1.44–4.02) and 90 days (HR = 2.23, 95% CI: 1.51–3.29) after nephrectomy. TKI treatment was not associated with an increased postoperative mortality at 30 and 90 days after surgery. Thus, TKI treatment was associated with an increased complication rate but not overall mortality following CN. Our results suggest that renal surgeons should be aware of possibly increased complications following CN in renal cell carcinoma patients, when TKI treatment is administered.

Details

Language :
English
ISSN :
20452322
Volume :
9
Issue :
1
Database :
OpenAIRE
Journal :
Scientific Reports
Accession number :
edsair.doi.dedup.....93aac601f30d7a8b702e90c1b8f64a61
Full Text :
https://doi.org/10.1038/s41598-019-51548-4