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Title: Changing trends in surgical management of renal tumours from 2000 to 2016: a nationwide study of Medicare claims data.
Austin Authors: Ali, Stephen;Ahn, Thomas;Papa, Nathan;Perera, Marlon ;Teloken, Patrick;Coughlin, Geoffrey;Wood, Simon T;Roberts, Matthew J
Affiliation: Department of Urology, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia
Department of Surgery, St Vincent's Hospital, Sydney, New South Wales, Australia
Faculty of Medicine, The University of New South Wales, Sydney, New South Wales, Australia
Department of Surgery, Austin Health, The University of Melbourne, Heidelberg, Victoria, Australia
Centre for Kidney Disease Research, Translational Research Institute, Brisbane, Queensland, Australia
Nepean Urology Research Group, Nepean Hospital, Sydney, New South Wales, Australia
Department of Urology, Princess Alexandra Hospital, Brisbane, Queensland, Australia
Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
Issue Date: Jan-2020
Date: 2019-09-02
Publication information: ANZ Journal of Surgery 2020; 90(1-2): 48-52
Abstract: Guidelines recommend nephron sparing surgery where possible for patients with T1 renal tumours. The trends of nephron sparing surgery outside the USA are limited, particularly since the introduction of robotic-assisted partial nephrectomy (RAPN). The aim of this study was to describe contemporary surgical management patterns of renal tumours in Australia according to Medicare claims data. Claims data according to the Medicare Benefits Schedule on surgical management of renal tumours in adult Australians between January 2000 and December 2016 was collated. Analysis of absolute number, population-adjusted rate and renal cancer-adjusted rate of interventions according to age and gender were performed, as well as proportion of RAPN. Between 2000 and 2016, the rate of partial nephrectomy (PN) increased while radical nephrectomy (RN) remained stable (PN: 0.87-4.16, RN: 6.52-6.70 per 100 000 population). Since 2015, PN has become more common than RN in patients aged 25 to 44 years (0.98 versus 0.95 procedures per 100 000 population). Renal cancer-adjusted rate exhibited a trend towards increasing utilization of PN and reduced RN across all age groups. An increase in overall surgical treatment was observed (25%-41%), mainly due to increased treatment of patients older than 75 years. The proportion of RAPN was seen to rapidly increase (4.7% in 2010 to 58% in 2016). Treatment utilization for renal masses has markedly changed in Australia according to Medicare claims. PN is increasingly replacing RN in younger patients, and older patients are receiving more surgical treatment. The impact of increased RAPN utilization is yet to be determined.
DOI: 10.1111/ans.15385
ORCID: 0000-0002-2808-9970
Journal: ANZ Journal of Surgery
PubMed URL: 31478323
Type: Journal Article
Subjects: laparoscopic nephrectomy
partial nephrectomy
radical nephrectomy
renal cell carcinoma
Appears in Collections:Journal articles

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