Postoperative 30-day Mortality Rates for Kidney Cancer Are Dependent on Hospital Surgical Volume: Results from a Norwegian Population-based Study

Hjelle, Karin M.; Johannesen, Tom Børge; Beisland, Christian

doi:10.1016/j.euf.2016.10.001

Cited by 15 publications

(13 citation statements)

References 84 publications

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“…Historical studies showed conflicting results for short‐term nephrectomy morbidity and mortality trends over time . We found clear improvements in surgical mortality, with the 30‐day mortality rate decreasing to 1.1% in 2010, similar to the 0.9–2.7% reported by other countries during the same time period . The greatest improvements were seen in elderly patients aged ≥65 years, suggesting greater safety in surgery with reduced outcome inequality for patients of different ages and were consistent with the improvements seen in other urological procedures .…”

Section: Discussionsupporting

confidence: 82%

Time trends in service provision and survival outcomes for patients with renal cancer treated by nephrectomy in England 2000–2010

et al. 2018

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ObjectiveTo describe the temporal trends in nephrectomy practice and outcomes for English patients with renal cell carcinoma (RCC).Patients and MethodsAdult RCC nephrectomy patients treated between 2000 and 2010 were identified in the National Cancer Data Repository and Hospital Episode Statistics, and followed‐up until date of death or 31 December 2015 (n = 30 763). We estimated the annual frequency for each nephrectomy type, the hospital and surgeon numbers and their case volumes. We analysed short‐term surgical outcomes, as well as 1‐ and 5‐year relative survivals.ResultsAnnual RCC nephrectomy number increased by 66% during the study period. Hospital number decreased by 24%, whilst the median annual hospital volume increased from 10 to 23 (P < 0.01). Surgeon number increased by 27% (P < 0.01), doubling the median consultant number per hospital. The proportion of minimally invasive surgery (MIS) nephrectomies rose from 1% to 46%, whilst the proportion of nephron‐sparing surgeries (NSS) increased from 5% to 16%, with 29% of all T1 disease treated with partial nephrectomy in 2010 (P < 0.01). The 30‐day mortality rate halved from 2.4% to 1.1% and 90‐day mortality decreased from 4.9% to 2.6% (P < 0.01). The 1‐year relative survival rate increased from 86.9% to 93.4%, whilst the 5‐year relative survival rate rose from 68.2% to 81.2% (P < 0.01). Improvements were most notable in patients aged ≥65 years and those with T3 and T4 disease.ConclusionsSurgical RCC management has changed considerably with nephrectomy centralisation and increased NSS and MIS. In parallel, we observed significant improvements in short‐ and long‐term survival particularly for elderly patients and those with locally advanced disease.

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Section: Discussionsupporting

confidence: 82%

Time trends in service provision and survival outcomes for patients with renal cancer treated by nephrectomy in England 2000–2010

et al. 2018

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“…It is well‐known that RAPN is technically challenging and associated with a significant risk of complications, albeit this complication rate remains lower than the open approach . Despite many studies having assessed the relationship between provider volume and RAPN outcomes , to our knowledge no study to date has analysed both HV and SV.…”

Section: Discussionmentioning

confidence: 99%

Impact of hospital volume and surgeon volume on robot‐assisted partial nephrectomy outcomes: a multicentre study

et al. 2018

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“…The effect of hospital volume on RCC patient outcomes has been a subject of interest and well characterised in widespread publications in recent years [12][13][14][15]. Most of these studies have concluded that higher hospital volume correlates to better outcomes particularly during the perioperative period.…”

Section: Discussionmentioning

confidence: 99%

Impact of hospital nephrectomy volume on intermediate to long-term survival in renal cell carcinoma

Hsu¹,

Barclay²,

Lyratzopoulos³

et al. 2018

European Urology Supplements

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To evaluate the relationship between hospital volume and intermediate and long-term patient survival for patients undergoing nephrectomy for renal cell carcinoma (RCC). PATIENTS & METHODS Adult RCC patients treated with nephrectomy between 2000 and 2010 were identified from the English Hospital Episode Statistics and National Cancer Data Repository. Patients with nodal or metastatic disease were excluded. Hospitals were categorised into low (<20/yr), medium (20-39/yr) and high (40/yr) volume based on annual cases of RCC nephrectomy. Multivariable Cox regressions were used to calculate hazard ratios for all-cause mortality by hospital volume, adjusting for patient, tumour and surgical characteristics. We assessed conditional survival over three follow-up periods: short (30d-1yr), intermediate (1-3yr) and long (3-5yr). We additionally explored whether associations between volume and outcomes varied by tumour stage.

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Postoperative 30-day Mortality Rates for Kidney Cancer Are Dependent on Hospital Surgical Volume: Results from a Norwegian Population-based Study

Cited by 15 publications

References 84 publications

Time trends in service provision and survival outcomes for patients with renal cancer treated by nephrectomy in England 2000–2010

Time trends in service provision and survival outcomes for patients with renal cancer treated by nephrectomy in England 2000–2010

Impact of hospital volume and surgeon volume on robot‐assisted partial nephrectomy outcomes: a multicentre study

Impact of hospital nephrectomy volume on intermediate to long-term survival in renal cell carcinoma

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