Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Mar 24;17(7):1083.
doi: 10.3390/cancers17071083.

Perioperative Outcomes After Radical Nephrectomy with Inferior Vena Cava Thrombectomy

Nikolaos Pyrgidis  1 , Gerald Bastian Schulz  1 , Christian G Stief  1 , Iulia Blajan  1 , Troya Ivanova  1 , Annabel Graser  1 , Michael Staehler  1
Affiliations

Perioperative Outcomes After Radical Nephrectomy with Inferior Vena Cava Thrombectomy

Nikolaos Pyrgidis et al. Cancers (Basel). .

Abstract

Background and objective: We aimed to evaluate current trends and complications after radical nephrectomy with inferior vena cava (IVC) thrombectomy and to provide evidence on the role of the annual hospital caseload on perioperative outcomes.

Methods: We used the GeRmAn Nationwide inpatient Data (GRAND), provided by the German Bureau of Statistics (2005-2022). All hospitals performing radical nephrectomy with IVC thrombectomy were subclassified based on their annual caseload to low- (<3 cases/year), intermediate- (3-9 cases/year), and high-volume centers (≥10 cases/year). We included 3608 patients. Key Findings and Limitations: Overall, 1880 (52%) patients underwent surgery in low-, 1466 (40%) in intermediate-, and 848 (8%) in high-volume centers. Most patients (3574, 99%) underwent open surgery. The number of patients undergoing radical nephrectomy with IVC thrombectomy has decreased in the last years. Patients undergoing surgery in low-, intermediate- and high-volume centers had similar baseline characteristics. Operation in high-volume centers, compared to low-volume centers, was associated with lower odds of intensive care unit admission (29% versus 45%, OR: 0.5, 95% CI: 0.4-0.7, p < 0.001) and a shorter hospital stay by 3.9 days (95% CI: 2.2-5.6, p < 0.001). Importantly, for every additional case performed annually, hospitals improve their perioperative outcomes in terms of mortality (p = 0.032), intensive care unit admissions (p = 0.002), acute kidney disease (p = 0.029), and length of hospital stay (p < 0.001).

Conclusions and clinical implications: The present real-world data demonstrate that, for every additional case performed annually, hospitals improve their perioperative outcomes in terms of major perioperative complications.

Keywords: cohort study; inferior vena cava thrombectomy; mortality; perioperative outcomes; radical nephrectomy.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
The annual trends for radical nephrectomy with inferior vena cava thrombectomy based on hospital caseload.
Figure 2
Figure 2
Kaplan–Meier curve for 30-day survival in patients undergoing radical nephrectomy with inferior vena cava thrombectomy based on hospital caseload.
See this image and copyright information in PMC

References

    1. Diana P., Klatte T., Amparore D., Bertolo R., Carbonara U., Erdem S., Ingels A., Kara O., Marandino L., Marchioni M., et al. Screening programs for renal cell carcinoma: A systematic review by the EAU young academic urologists renal cancer working group. World J. Urol. 2023;41:929–940. doi: 10.1007/s00345-022-03993-6. - DOI - PMC - PubMed
    1. Whitson J.M., Reese A.C., Meng M.V. Population based analysis of survival in patients with renal cell carcinoma and venous tumor thrombus. Urol. Oncol. Semin. Orig. Investig. 2013;31:259–263. doi: 10.1016/j.urolonc.2010.11.017. - DOI - PubMed
    1. Wagner B., Patard J.-J., Méjean A., Bensalah K., Verhoest G., Zigeuner R., Ficarra V., Tostain J., Mulders P., Chautard D., et al. Prognostic value of renal vein and inferior vena cava involvement in renal cell carcinoma. Eur. Urol. 2009;55:452–459. doi: 10.1016/j.eururo.2008.07.053. - DOI - PubMed
    1. Ciancio G., Manoharan M., Katkoori D., De Los Santos R., Soloway M.S. Long-term survival in patients undergoing radical nephrectomy and inferior vena cava thrombectomy: Single-center experience. Eur. Urol. 2010;57:667–672. doi: 10.1016/j.eururo.2009.06.009. - DOI - PubMed
    1. Martin T., Huber J., Koch R., Butea-Bocu M., Haak L., Flegar L., Giese M., Kormann F., Aksoy C., Zacharis A., et al. Defining a threshold for safe surgical management of vena cava thrombus in renal cell carcinoma patients: Evidence from German total population data with 3,700 cases from 2006 to 2020. World J. Urol. 2024;43:1. doi: 10.1007/s00345-024-05360-z. - DOI - PMC - PubMed

LinkOut - more resources