An increase in tumor size increases the risk of the development of postoperative cardiopulmonary events in patients undergoing partial nephrectomy.

PURPOSE

The aim of this study was to examine the effect of kidney tumor size on the risk of CPE developing in the first postoperative month.

MATERIAL AND METHODS

Evaluation was made of 127 patients who underwent PN between January 2010 and November 2022. The patients were separated into two groups as Group 1 (n: 13) including patients who developed CPE within the first postoperative month and Group 2 (n: 114) of patients who did not develop CPE. The factors that could affect CPE and overall survival were analyzed with multivariate logistic and Cox regression analysis, respectively.

RESULTS

The groups were determined to be similar in respect of age, gender and Charlson Comorbidity Index (p = 0.35, p = 0.68, p = 0.42, respectively). The values of mean tumor size (48.6 ± 12.9 vs. 29.2 ± 8.7 mm, p < 0.001), clinical T1b stage (61.5% vs. 9.6%, p < 0.001), median R.E.N.A.L. Nephrometry Score (9[3] vs.6 [1], p = 0.001) and mean warm ischaemia time (21.2 ± 3.5 vs. 15.9 ± 2.63 min, p < 0.001) were determined to be statistically significantly higher in Group 1 than in Group 2. In the ROC curve analysis performed to predict the development of CPE within the first postoperative month, 35.5 mm was determined to be the best cut-off point for tumor diameter (AUC = 0.88, p < 0.001). In the multivariate analysis, the presence of CPE for overall survival, and increased tumor size for the development of CPE were each determined to be independent risk factors (OR: 3.25, p = 0.03; OR: 1.4, p = 0.001, respectively).

CONCLUSION

Tumor size serves as a significant marker for the development of CPE within the initial month following PN.