Outcome of Nephrectomies in Malta since 2000

Abstract

Aim: To audit the oncological results and perioperative surgical outcome of nephrectomies performed in Malta since year 2000. Method: A retrospective index case list of all nephrectomies carried out by three urological surgeons at St Luke’s and Mater Dei Hospitals from 1st September 2000 to 31st March 2012 was compiled from departmental data. Clinical, radiological and histological data were compiled from the case notes and hospital intranet computerised investigation results. Clinical staging of all patients was revised using the Union Internationale Contre le Cancer TNM staging 2009. All the patients who underwent nephrectomy for clear cell renal cell carcinoma were stratified according to individual predicted prognosis based on the SSIGN score developed by the Mayo clinic. Results: Between September 2000 and March 2012, 319 nephrectomies were carried out at the Urology Unit, of these 288 were carried out for malignancy, 218 of which were clear cell renal cell carcinoma (RCC). 112 complications were recorded for the whole cohort; two patients died from perioperative complications. 80 patients passed away, 51 of these as a direct consequence of their renal cell cancer. Median duration of follow up was 42.7 months. A Cox model reveals that a SSIGN score greater than 6 significantly worsens survival rate for RCC (p<<0.001). Conclusion: Morbidity following surgery, mortality rates, and oncological results in our single centre study are acceptable when compared to larger series.