MP67-17 IS A PREOPERATIVE LOW EJECTION FRACTION A RISK FACTOR FOR COMPLICATIONS AND IMPAIRED SURVIVAL IN RENAL CANCER PATIENTS WHO UNDERGO SURGERY? RESULTS FROM A PROPENSITY-SCORE MATCHING WITH NON CARDIOPATHIC COUNTERPARTS

Field: Medicine (Health Sciences)

You have accessJournal of UrologyKidney Cancer: Epidemiology & Evaluation/Staging II1 Apr 2017MP67-17 IS A PREOPERATIVE LOW EJECTION FRACTION A RISK FACTOR FOR COMPLICATIONS AND IMPAIRED SURVIVAL IN RENAL CANCER PATIENTS WHO UNDERGO SURGERY? RESULTS FROM A PROPENSITY-SCORE MATCHING WITH NON CARDIOPATHIC COUNTERPARTS Alessandro Nini, Alessandro Larcher, Fabio Muttin, Emanuele Zaffuto, Paolo Dell'Oglio, Francesco Ripa, Cristina Carenzi, Giovanni La Croce, Gabriele Fragasso, Francesco Montorsi, Umberto Capitanio, and Roberto Bertini Alessandro NiniAlessandro Nini More articles by this author , Alessandro LarcherAlessandro Larcher More articles by this author , Fabio MuttinFabio Muttin More articles by this author , Emanuele ZaffutoEmanuele Zaffuto More articles by this author , Paolo Dell'OglioPaolo Dell'Oglio More articles by this author , Francesco RipaFrancesco Ripa More articles by this author , Cristina CarenziCristina Carenzi More articles by this author , Giovanni La CroceGiovanni La Croce More articles by this author , Gabriele FragassoGabriele Fragasso More articles by this author , Francesco MontorsiFrancesco Montorsi More articles by this author , Umberto CapitanioUmberto Capitanio More articles by this author , and Roberto BertiniRoberto Bertini More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2017.02.2053AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Little is known about the impact of reduced left ventricular ejection fraction (rLVEF) on outcomes of patients undergoing surgery for renal cell carcinoma (RCC). The aim of our study was to compare complication rate, perioperative mortality, other-cause mortality (OCM) and overall mortality (OM) between cardiopathic patients (rLVEF) and matched controls. METHODS Between 1990 and 2016, 2,974 consecutive patients treated with surgery for RCC were collected into an institutional database. When LVEF was <50% at preoperative transthoracic cardiac ultrasound, patients were classified as rLVEF, according to European Society of Cardiology Guidelines. Propensity-score matching was performed between patients with rLVEF and controls without rLVEF with a 1-to-4 ratio, after adjusting for age, body mass index, comorbidities (diabetes, hypertension and Charlson Comorbidity Index) and tumour characteristics (TNM classification). RESULTS After matching 1:4, 175 patients (35 rLVEF vs. 140 controls) were included in the analyses. In the matched cohort, no differences were recorded in terms of baseline clinical features and tumor characteristics. Low grade complications (Clavien-Dindo I-II) were reported in 20% of controls vs. 41% of rLVEF patients (p<0.01). High grade complications (Clavien-Dindo III-IV) were reported in 4% vs. 2.5% (p=0.6) in the control vs. rLVEF groups, respectively. Thirty-day and 90-day mortality rates were 1.3% and 1.4% in the control group vs. 0% and 0% in rLVEF counterparts (all p=0.9). At 1, 5 and 10 years after surgery, OCM resulted 3.2%, 12.5% and 26% vs. 0%, 17.8% and 38.3% in controls vs. rLVEF (p=0.2). Correspondingly, at 1, 5 and 10 years after surgery, OM resulted 4.9%, 22.8% and 40.4% vs. 3.3%, 34.2% and 76.7% in controls vs. rLVEF (p=0.6). CONCLUSIONS After matching, patients with rLVEF experienced more frequently minor complications (Clavien-Dindo I-II) relative to controls. However, no differences in terms of high grade complications (Clavien-Dindo III-IV) and perioperative mortality were observed after surgery when patients with preoperative rLVEF were compared to equivalent non cardiopathic counterparts. When long-term survival outcomes were taken into consideration, no difference was recorded according to cardiopathic status. © 2017FiguresReferencesRelatedDetails Volume 197Issue 4SApril 2017Page: e878 Advertisement Copyright & Permissions© 2017MetricsAuthor Information Alessandro Nini More articles by this author Alessandro Larcher More articles by this author Fabio Muttin More articles by this author Emanuele Zaffuto More articles by this author Paolo Dell'Oglio More articles by this author Francesco Ripa More articles by this author Cristina Carenzi More articles by this author Giovanni La Croce More articles by this author Gabriele Fragasso More articles by this author Francesco Montorsi More articles by this author Umberto Capitanio More articles by this author Roberto Bertini More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...