https://doi.org/10.4081/aiua.2022.2.129

Outcomes of nephrectomy for renal cell carcinoma: An ecologic retrospective study in a middle-income country

Vol. 94 No. 2 (2022)
Submitted: March 25, 2022
Accepted: May 31, 2022
Published: June 28, 2022
Nephrectomy; Renal cell carcinoma; Mortality rates; Teaching Hospital.
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Authors

Alexandre Dib Partezani
Department of Urology, Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
Hugo Octaviano Duarte-Santos
Department of Urology, Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
Breno Santos Amaral
Department of Urology, Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
Alan Roger Gomes Barbosa
Department of Urology, Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
Marcelo Apezzato
Department of Urology, Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
João Brunhara
Department of Urology, Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
Bianca Bianco
bianca.bianco@einstein.br
Department of Urology, Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
Gustavo Caserta Lemos
Department of Urology, Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
Arie Carneiro
Department of Urology, Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.

Objective: The aim of this study was to describe and compare the outcomes and indirect costs of oncological radical (RN) and partial nephrectomies (PN) in hospitals from the São Paulo public health system, Brazil.
Materials and methods: An ecologic retrospective study was performed from 2008 to 2019, using the TabNet Platform of the Brazilian Unified Health System Department of Informatics. Hospitals were classified according to volume of surgeries (low and high-volume, and also into four quartiles according to volume of surgeries), and with or without medical residency program in urology. The results were compared between groups.
Results: In the period analyzed were performed 2.606 RN in 16 hospitals. Data available for PN ranged only from 2013-2019 and included 1.223 surgeries comprising 15 hospitals. Overall mortality rates were 0.41% for PN and 2.87% for RN. The length of hospital stay was significantly higher in low-volume hospitals for both RN and PN (8.97 vs. 5.62 days, p = 0.001, and 7.75 vs. 4.37 days, p = 0.001, respectively), and also for the RN in hospitals without residency program in Urology (9.37 vs. 6.54 days, p = 0.03). When the volume of surgeries was divided into four quartiles, the length of hospital stay and ICU hospitalization days were significantly higher in the first quartile hospitals for RN (p = 0.016) and PN (p = 0.009), respectively. The mortality rates and indirect costs were not different considering PN and RN in the different types of hospitals.
Conclusions: The length of hospital stay was significantly lower for both PN and RN in high-volume hospitals, and also for RN in hospitals with residency program in Urology.

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How to Cite

Partezani, A. D., Duarte-Santos, H. O. ., Amaral, B. S., Gomes Barbosa, A. R. ., Apezzato, M. ., Brunhara, J. ., Bianco, B., Lemos, G. C., & Carneiro, A. (2022). Outcomes of nephrectomy for renal cell carcinoma: An ecologic retrospective study in a middle-income country. Archivio Italiano Di Urologia E Andrologia, 94(2), 129–133. https://doi.org/10.4081/aiua.2022.2.129

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