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Laparoscopic Radical Nephrectomy for Renal Cell Carcinoma: Oncological Outcomes at 10 Years or More

Authors
Journal
The Journal of Urology
0022-5347
Publisher
Elsevier
Publication Date
Volume
182
Issue
5
Identifiers
DOI: 10.1016/j.juro.2009.07.047
Keywords
  • Kidney
  • Nephrectomy
  • Carcinoma
  • Renal Cell
  • Laparoscopy
  • Outcome Assessment (Health Care)
Disciplines
  • Biology
  • Medicine

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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