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ORIGINAL RESEARCH article

Front. Oncol.
Sec. Surgical Oncology
Volume 14 - 2024 | doi: 10.3389/fonc.2024.1453346

Correlation Analysis of Preoperative Renal Insufficiency with Major Complications in Patients Received Radical Cystectomy and Pelvic Lymph Node Dissection: Results of A Retrospective Observational Analysis from A Single Center

Provisionally accepted
Haixin Wang Haixin Wang 1,2Haiwen Huang Haiwen Huang 3*Han Hao Han Hao 1*Zhijun Xi Zhijun Xi 1*
  • 1 First Hospital, Peking University, Beijing, China
  • 2 Yankuang New Journey General Hospital, Zoucheng, China
  • 3 Beijing Tsinghua Changgeng Hospital, Tsinghua University, Beijing, Beijing Municipality, China

The final, formatted version of the article will be published soon.

    Objective: The aim of this study is to explore the factors affecting the major complications, and figure out the impacts of preoperative renal function on the incidence of complications in radical cystectomy procedures. Methods: Retrospective review of 705 patients who received radical cystectomy between 2006 and 2021. The 90-d complications of patients after radical cystectomy were reported and the Clavien-Dindo classification (CDC) was used for grading complications. Clinical characteristics and preoperative outcomes were compared among patients with different preoperative renal functions. The Logistic regression analysis of all patients was used to identify the risk factors associated with the major complications. The Spearman correlation analysis was used to examine the relationship between classification of renal insufficiency and CDC. In order to reduce the selection bias, a one-to-one propensity score matching was performed, and the comparison of complications after matching was carry out for the sensitivity analysis. Results: Within 90 days post-surgery, 71% of patients experienced complications, with 4.8% being major. Patients with preoperative renal insufficiency had higher CDC, and had higher rate of major complications (16.7% vs 3.7%, p < 0.001). There was a linear relationship between preoperative serum creatinine and complications. Spearman correlation analysis showed a slightly positive correlation between classification of renal insufficiency and CDC (r=0.094, p = 0.013). Preoperative renal insufficiency was the risk factor of major complications (OR = 6.805 [95%CI: 2.706-17.112]; p < 0.001). After matching, the patients of preoperative renal insufficiency group had higher CDC and higher incidence of major complications (16.9% vs 1.7%, p = 0.004). Conclusions: In our cohort, patients with preoperative renal insufficiency exhibit a higher incidence of complications following radical cystectomy, and renal insufficiency was a significant risk factor for major complications.

    Keywords: Radical cystectomy, Renal function, Renal Insufficiency, complications, Clavien-Dindo

    Received: 23 Jun 2024; Accepted: 28 Oct 2024.

    Copyright: © 2024 Wang, Huang, Hao and Xi. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence:
    Haiwen Huang, Beijing Tsinghua Changgeng Hospital, Tsinghua University, Beijing, 102218, Beijing Municipality, China
    Han Hao, First Hospital, Peking University, Beijing, China
    Zhijun Xi, First Hospital, Peking University, Beijing, China

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