A clinical audit of adverse post-nephrectomy outcomes in renal cell carcinoma patients at a tertiary hospital in Queensland, Australia
de Souza, Julia Chequer, Vangaveti, Venkat, Biros, Erik, and Mallett, Andrew J. (2025) A clinical audit of adverse post-nephrectomy outcomes in renal cell carcinoma patients at a tertiary hospital in Queensland, Australia. Journal of Nephrology, 38 (5). pp. 1357-1368.
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Abstract
Background: Renal cell carcinoma (RCC) is a common malignancy, and nephrectomy is the mainstay of treatment for non-metastatic disease. The choice of surgery depends on the risks of oncologic recurrence, kidney function decline, and perioperative complications. This study aimed to identify factors associated with adverse post-operative outcomes in RCC patients undergoing nephrectomy at Townsville University Hospital (TUH). Methods: This was a retrospective, quality assessment study of all adult patients undergoing either open or laparoscopic, partial, or radical nephrectomy for suspected RCC at TUH between January 1, 2016, and December 31, 2020. Patients were identified from the Queensland Health Admitted Data Collection, with a median follow-up time of 39 months post-operatively. Results: Sixty patients were included; 71.7% underwent radical nephrectomy, and 63.3% were treated with a laparoscopic approach. Adverse kidney function outcomes were identified in 76.7% of patients. In the first 30 days post-nephrectomy, the reduction in estimated glomerular filtration rate (eGFR) in the radical nephrectomy group was more than double that in the partial nephrectomy group (p < 0.001). The rise in average serum creatinine post-radical nephrectomy was more than six times that post-partial nephrectomy (p = 0.001). This discrepancy in kidney function persisted up to three years post-operatively. No significant differences in RCC recurrence, post-operative cardiovascular events, or mortality were observed between partial nephrectomy and radical nephrectomy (p = 0.665, p = 1.00, p = 0.420). Conclusions: The balance strongly favours partial nephrectomy despite its underutilisation for patients undergoing nephrectomy for suspected non-metastatic RCC at TUH. Urology teams should weigh the factors favouring radical nephrectomy against the risks of nearly universal renal function decline in this group.
| Item ID: | 87991 |
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| Item Type: | Article (Research - C1) |
| ISSN: | 1724-6059 |
| Keywords: | Chronic kidney disease, Outcomes, Partial nephrectomy, Radical nephrectomy, Renal cell carcinoma |
| Copyright Information: | © The Author(s) 2024. This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. |
| Date Deposited: | 09 Mar 2026 05:42 |
| FoR Codes: | 32 BIOMEDICAL AND CLINICAL SCIENCES > 3202 Clinical sciences > 320214 Nephrology and urology @ 100% |
| SEO Codes: | 20 HEALTH > 2001 Clinical health > 200199 Clinical health not elsewhere classified @ 100% |
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