TITLE:
Use of the American Society of Anesthesiologists Classification as an Additional Planning Tool for Renal Cell Carcinoma Assessment
AUTHORS:
Daniel Beltrame Ferreira, Stênio de Cássio Zequi, Walter Henriques da Costa, Diego Abreu Clavijo, Ricardo Decia, Deusdedit Cortez Neto, Renato Rosa de Oliveira, Gustavo Cardoso Guimarães, Ademar Lopes
KEYWORDS:
Comorbidity; Renal Cell Carcinoma; ASA; Prognosis; Oncology
JOURNAL NAME:
Journal of Cancer Therapy,
Vol.4 No.9B,
October
16,
2013
ABSTRACT:
Objective: To determine the prognostic value of
the American Society of Anesthesiologists (ASA) classification and of the main
clinical pathologic variables in renal cell carcinoma (RCC) patients who
underwent surgical treatment. Methods: In this international collaborative study, 376 RCC patients who
underwent partial nephrectomy (PN) or radical nephrectomy (RN) during the
period 1989-2009
were assessed. The pathological data were reviewed by a single pathologist, and
all of the surgically treated patients had been previously evaluated by a team
of anesthesiologists and classified as ASA 1, ASA 2, or ASA 3. Results: In total, 318
patients were included in the study, with a mean followup of 48 months.
Incidental tumors represented 47% of the cases, while 11.6% presented with
metastases at diagnosis. Among the patients assessed, 38 (11.9%) were
classified as ASA 1, 213 (67%) as ASA 2, and 67 (21.1%) as ASA 3. An
association between the ASA classification and the main clinicopathological
variables of RCC was observed. The univariate analysis for overall survival
(OS) revealed significant differences in the survival curves according to the ASA
classification (p Conclusions: The present
study demonstrated a correlation between the ASA classification and the main
prognostic factors of RCC and its impact on survival rates. ASA 3 patients had
more aggressive tumors, increased risk of perioperative complications, and
worse outcomes compared with ASA1 or ASA 2. Thus, the ASA classification may be
considered an additional tool for assessing and planning the treatment of RCC
patients.