转移性肾细胞癌（mRCC）的手术切除与更好的癌症特异性存活有关；然而，其围手术期发病率方面的高质量数据缺乏。现有的基于人口的数据严重受到依赖计费索赔以确定结果的限制，这可能会由于缺乏代码的特异性而高估事件。本研究旨在研究mRCC的转移切除术后30天并发症。这项研究涉及2005年至2020年在两个高容量中心接受mRCC的转移切除术的患者的回顾性队列。我们使用广义估计方程来评估特征与Clavien-Dindo分级分类的30天并发症之间的关联。确定了522名患者中的740个转移切除手术，其中包括在Mayo Clinic进行的543个和在UZ Leuven进行的197个。在740个转移切除手术中，有193个（26%，95%可信区间[CI]23-29%）出现了30天并发症，其中62个（8%，95%CI 7-11%）出现了严重（Clavien-Dindo III-V）并发症，包括8个（1%）围手术期死亡。年龄、身体质量指数 、麻醉学美国学会评分、与肾切除同时进行的转移切除、多个转移部位、胰腺切除、转移大小等因素均与术后并发症有显着关联（所有p<0.05）。年龄、多个转移部位和胰腺切除与严重（Clavien-Dindo III-V）并发症有显着关联（所有p<0.05）。本研究的局限性包括回顾性设计和手术选择偏差。在这个多机构系列中，不到10%的mRCC 患者的转移切除术在手术后的30天内出现了严重并发症，这比先前人口数据观察到的要低得多。在收选的患者和高容量中心，METASTASECTOMY可以获得有利的围术期结果。本研究发现，在接受了一次或多次转移性肾癌手术切除的患者中，少于10%的患者在手术后30天内出现了严重并发症。版权所有©2022欧洲泌尿科协会。由Elsevier B.V.发表。保留所有权利。

Surgical resection of metastatic renal cell carcinoma (mRCC) has been associated with better cancer-specific survival; however, high-quality data on its perioperative morbidity are lacking. Existing population-based data are severely limited by reliance on billing claims to identify outcomes, which may overestimate events owing to a lack of code specificity.To study 30-d complications after metastasectomy for mRCC.The study involved a retrospective cohort of patients who underwent metastasectomy for mRCC between 2005 and 2020 at two high-volume centers.We used generalized estimating equations for a binary response to evaluate associations of features with 30-d complications classified according to Clavien-Dindo grade.A total of 740 metastasectomies in 522 patients were identified, including 543 performed in the Mayo Clinic and 197 in UZ Leuven. Among the 740 metastasectomies, 193 (26%, 95% confidence interval [CI] 23-29%) had a 30-d complication and 62 (8%, 95% CI 7-11%) had a major (Clavien-Dindo III-V) complication, including eight (1%) perioperative deaths. Age, body mass index, American Society of Anesthesiologists score, metastasectomy concurrent with nephrectomy, multiple sites of metastasis, pancreatic resection, and metastasis size were significantly associated with postoperative complications (all p < 0.05). Age, multiple sites of metastasis, and pancreatic resection were significantly associated with major (Clavien-Dindo III-V) complications (all p < 0.05). Limitations include the retrospective design and surgical selection bias.In this multi-institutional series, fewer than 10% of metastasectomies for mRCC resulted in a major complication within 30 d of surgery, which is considerably lower than previously observed in population-based data. Favorable perioperative outcomes can be achieved with metastasectomy at high-volume centers in well-selected patients.In this study we found that fewer than 10% of patients who underwent surgical removal of one or more sites of metastatic kidney cancer experienced a major complication within 30 days of surgery.Copyright © 2022 European Association of Urology. Published by Elsevier B.V. All rights reserved.