The relationship of Charlson comorbidity index and postoperative complications in elderly patients after partial or radical nephrectomy

Objectives: To compare preoperative Charlson comorbidity Index (CCI) and postoperative complications after oncologic kidney surgery in patients aged 70 or older. To compare CCI and need for interdisciplinary evaluation, consults to the emergency department and need of readmission are secondary objectives.Patients and methods: This is a retrospective cohort study. Patients aged 70 or older who underwent partial or radical nephrectomy were collected from an institutional database. Period: February 2012–June 2014. Association between CCI and complications was estimated using Chi2.Results: Final population: 143 (male: 65%). Age median was 75. Minor postoperative complications were 33.88% (n = 41) for patients CCI ≤ 4 versus 9.09% (n = 2) for patients CCI > 4 (p > 0.05), and major postoperative complications were 9.91% (n = 12) versus 45.45% (n = 10), respectively (p < 0.01). Interdisciplinary evaluation was required for 30.6% (n = 37) of patients CCI ≤ 4 versus 59% (n = 13) of patients CCI > 4 (p = 0.01). Readmission was needed for 9.09% (n = 11) and 40.1% (n = 11) respectively (p < 0.01).Conclusions: Patients with high comorbidity presented more major postoperative complications. These patients also required more interdisciplinary evaluation after surgery. A higher CCI was not associated with further consults to the emergency department or readmission

One-step nucleic acid amplification (Osna) of sentinel lymph node in early-stage endometrial cancer: Spanish multicenter study (endo-osna)

The objective of this study was to evaluate the efficacy of one-step nucleic acid amplification (OSNA) for the detection of sentinel lymph node (SLN) metastasis compared to standard pathological ultrastaging in patients with early-stage endometrial cancer (EC). A total of 526 SLNs from 191 patients with EC were included in the study, and 379 SLNs (147 patients) were evaluated by both methods, OSNA and standard pathological ultrastaging. The central 1 mm portion of each lymph node was subjected to semi-serial sectioning at 200 µm intervals and examined by hematoxylin–eosin and immunohistochemistry with CK19; the remaining tissue was analyzed by OSNA for CK19 mRNA. The OSNA assay detected metastases in 19.7% of patients (14.9% micrometastasis and 4.8% macrometastasis), whereas pathological ultrastaging detected metastasis in 8.8% of patients (3.4% micrometastasis and 5.4% macrometastasis). Using the established cut-off value for detecting SLN metastasis by OSNA in EC (250 copies/µL), the sensitivity of the OSNA assay was 92%, specificity was 82%, diagnostic accuracy was 83%, and the negative predictive value was 99%. Discordant results between both methods were recorded in 20 patients (13.6%). OSNA resulted in an upstaging in 12 patients (8.2%). OSNA could aid in the identification of patients requiring adjuvant treatment at the time of diagnosis. © 2021 by the authors. Licensee MDPI, Basel, Switzerland