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Scand J Urol. 2017 Oct;51(5):360-366. doi: 10.1080/21681805.2017.1326524. Epub 2017 Jun 23.

Contemporary treatment of renal tumors: a questionnaire survey in the Nordic countries (the NORENCA-I study).

Author information

1
a Department of Urology , Helsinki University Hospital , Helsinki , Finland.
2
b Department of Urology , Sahlgrenska University Hospital , Gothenburg , Sweden.
3
c Department of Urology , Landspitali University Hospital , Reykjavik , Iceland.
4
d Department of Urology , Herlev University Hospital , Copenhagen , Denmark.
5
e Department of Surgical and Perioperative Sciences, Urology and Andrology , Umeå University , Umeå , Sweden.
6
f Department of Urology , Odense University Hospital , Odense , Denmark.
7
g Clinical Institute , Southern University of Denmark , Odense , Denmark.
8
h Department of Urology , Akershus University Hospital , Lörenskog , Norway.
9
i Department of Urology, Faculty of Medicine and Health , Örebro University , Örebro , Sweden.
10
j Department of Urology , Haukeland University Hospital , Bergen , Norway.
11
k Department of Clinical Medicine , University of Bergen , Bergen , Norway.

Abstract

OBJECTIVE:

The five Nordic countries comprise 25 million people, and have similar treatment traditions and healthcare systems. To take advantage of these similarities, a collaborative group (Nordic Renal Cancer Group, NORENCA) was founded in 2015.

MATERIALS AND METHODS:

A questionnaire of 17 questions on renal tumor management and surgical education was designed and sent to 91 institutions performing renal tumor surgery in 2015. The response rate was 68% (62 hospitals), including 28 academic, 25 central and nine district hospitals. Hospital volume was defined as low (LVH: < 20 operations), intermediate (IVH: 20-49 operations), high (HVH: 50-99) and very high (VHVH: ≥ 100). Descriptive statistics were performed.

RESULTS:

Fifteen centers were LVH, 16 IVH, 21 HVH and 10 VHVH. Of all 3828 kidney tumor treatments, 55% were radical nephrectomies (RNs), 37% partial nephrectomies (PNs) and 8% thermoablations. For RN and PN, the percentages of open, laparoscopic and robotic approaches were 47%, 40%, 13% and 47%, 20%, 33%, respectively. The mean complication rate (Clavien-Dindo 3-5) was 4.9%, and 30 day mortality (TDM) was 0.5%. The median length of hospital stay was 4 days. Training with a simulator, black box or animal laboratory was possible in 48%, 74% and 21% of institutions, respectively.

CONCLUSIONS:

Despite some differences between countries, the data suggest an overall general common Nordic treatment attitude for renal tumors. Furthermore, the data demonstrate high adherence to international standards, with a high proportion of PN and acceptable rates for major complications and TDM.

KEYWORDS:

Complication; kidney cancer; minimally invasive methods; mortality; nephrectomy; surgery

PMID:
28644697
DOI:
10.1080/21681805.2017.1326524
[Indexed for MEDLINE]

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