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  • Title: Laparoscopic radical nephrectomy for renal cell carcinoma: oncological outcomes at 10 years or more.
    Author: Berger A, Brandina R, Atalla MA, Herati AS, Kamoi K, Aron M, Haber GP, Stein RJ, Desai MM, Kavoussi LR, Gill IS.
    Journal: J Urol; 2009 Nov; 182(5):2172-6. PubMed ID: 19758651.
    Abstract:
    PURPOSE: We present oncological outcomes at a followup of 10 years or greater after laparoscopic radical nephrectomy for cancer. MATERIALS AND METHODS: Between February 1994 and March 1999 a total of 73 laparoscopic radical nephrectomies were performed by 2 surgeons for pathologically confirmed renal cell carcinoma. Data were obtained from patient charts, radiographic reports, telephone followup and a check of the Social Security Death Index. RESULTS: Mean followup was 11.2 years (range 10 to 15). Each patient completed a minimum 10-year followup. Mean patient age at surgery was 60 years. Mean tumor size on computerized tomography was 5 cm (range 1.7 to 13). Pathological stage was pT1a in 41% of cases, pT1b in 30%, pT2 in 15%, pT3a in 10%, pT3b in 3% and pT4 in 1%. High grade tumors (Fuhrman 3 or greater) were present in 18 cases (28%). A positive surgical margin occurred in 1 case. Actual 10-year overall, cancer specific and recurrence-free survival rates were 65%, 92% and 86%, respectively. Overall, cancer specific and recurrence-free survival rates at 12 years were 35%, 78% and 77%, respectively. At a mean of 67 months 10 patients (14%) had metastatic disease, of whom 8 (11%) died. CONCLUSIONS: Long-term oncological outcomes after laparoscopic radical nephrectomy for renal cell carcinoma are excellent and appear comparable to those of open surgery.
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