Brief communication (Original). Predictive factors for postoperative complications in radical nephrectomy for renal cell carcinoma

Background: Radical nephrectomy is the treatment of choice for large renal cell carcinoma (RCC). Objectives: To describe the complications after radical nephrectomy for suspected or proven RCC and analyze the risk factors. Materials and methods: We retrospectively reviewed medical records from 110 patients who underwent radical nephrectomy for RCC in our institution between January 2007 and December 2013. The clinicopathologica I data of all patients were recorded and complications were graded using modified Clavien classification. Univariate and multivariate analysis was made of the predictive factors for complications. Results: Fifty postoperative complications occurred in 34 patients (31%) within 30 days, including 11% transfusion related complications. There were 22% minor complications (6% grade 1, 16% grade 2) and 9% major complication (5% grade 3,2% grade 4, and 2% grade 5). The most common complications were transfusion-related, re-laparotomy because of bleeding, and prolong ileus. In univariate analysis, pathological T-stage (P = 0.001), American Society of Anesthesiologists (ASA) score (P= 0.007), tumor size (P= 0.01), and tumor diameter >4 cm (P= 0.03) were significant predicting factors. Major Charlson comorbidity index (CCI >2) was the only significant factor for major complications (P= 0.04). In multivariate analysis, ASA score was a significant independent predictor for overall complications (odds ratio 4.83, P= 0.01). Conclusions: ASA score was a significant predictive factor for overall postoperative complications. Comorbidities was also a predictor for major complications in radical nephrectomy. Preoperative risk stratification for complications should be considered during decision-making and for proper counseling of patients.