In a recent study, researchers highlighted immediate cardiopulmonary risks associated with patients undergoing minimally invasive partial nephrectomy or prostatectomy for low-grade, low-stage disease.

The study compared these risks with those associated with disease surveillance.

Researchers will present these findings during the virtual American Urologic Association 2021 Annual Meeting.

“The impetus of this project was that for both of these—prostate cancer and kidney cancer—for low-grade, low-stage disease, active surveillance has been established as a viable and reasonable oncological treatment,” said Kevin Ginsburg, MD, lead author on the study and second-year fellow in the Urologic Oncology Fellowship Program at Fox Chase.

“In debating treatment versus observation, part of that calculus is the downside of treatment.

If a patient can safely undergo treatment, should they just undergo surgery and then not have to worry about watching their condition in the future?” added Ginsburg, who conducted the study with colleagues from the Division of Urology and Urologic Oncology at Fox Chase.

Researchers examined information from the American College of Surgeons National Surgical Quality Improvement Program database for patients undergoing minimally invasive prostatectomies and minimally invasive partial nephrectomies from 2015 to 2019.

Cardiopulmonary events noted in the study included pneumonia, deep vein thrombosis, pulmonary embolism, stroke, myocardial infarction, cardiovascular arrest, and death.

“We found that of the nearly 65,000 patients that underwent minimally invasive prostatectomy or partial nephrectomy in this registry, around 2% of them had a cardiopulmonary event within 30 days, including 87 patients who unfortunately died within 30 days,” said Ginsburg.

In comparing these cardiopulmonary events with other postoperative outcomes like readmission and length of stay, patients who had these cardiopulmonary events were much more likely to be readmitted, have a longer stay, and have reoperations, Ginsburg said.

“If we think about it, the perioperative risks of surgery are immediate and around 2%. The oncological risks with not treating someone with surgery are typically delayed to five or 10 years down the line, which is a similar risk of around 2% or 3% of dying from a cancer like this,” said Ginsburg.

He added that findings gleaned from this study should be integrated into the shared decision-making process in patients for which active surveillance has been established as an oncologically safe option.

The study, “Understanding the Risks of Surgery in Urologic Patients with Low Risk Cancers: Quantifying Perioperative Cardiopulmonary Events Following Minimally Invasive Prostatectomy and Partial Nephrectomy,” was published in The Journal of Urology.

Source: Fox Chase Cancer Center