title: Metastatic renal cell cancer after laparoscopic radical nephrectomy: long-term follow-up.
abstract: OBJECTIVE
  To assess the risk of metastatic disease in longer-term follow-up of patients undergoing laparoscopic radical nephrectomy with morcellation for renal cell carcinoma (RCC).
  
  
  METHODS
  We present the findings at follow-up at 13.5 to 70 months (mean 33.4 months) of 57 previously reported patients. Three, all of whom initially had clinical stage N0M0 disease, were found to have metastases. One, who had a clinical stage T3 grade III/IV tumor, developed an asymptomatic recurrence in the renal fossa with associated chest metastasis 14 months postoperatively. The second, who had a clinical stage T2 grade II/IV tumor, developed painful bony lesions and a chest metastasis 20 months postoperatively. The third patient, with a clinical stage T3 grade IV/IV tumor, was found to have a solitary port-side abdominal-wall recurrence with no other evidence of metastatic disease at 25 months.
  
  
  CONCLUSIONS
  Longer-term follow-up has demonstrated a 5% (3/57) rate of metastases after laparoscopic radical nephrectomy. In two of these patients, the course was consistent with the natural history of RCC; however, the third had a port-site recurrence. Thus, it behooves us to be meticulous with our technique and to follow patients closely after laparoscopic nephrectomy. Several suggestions are made to reduce the likelihood of port-site recurrence.
authors.affiliation: University of Saskatchewan, Sastakoon, Canada.
authors.forename: D D
authors.initials: DD
authors.lastname: Fentie
authors.forename: P H
authors.initials: PH
authors.lastname: Barrett
authors.forename: L A
authors.initials: LA
authors.lastname: Taranger
mesh_terms: D000368:Aged; D001859:Bone Neoplasms / Q000473:pathology / Q000556:secondary; D002292:Carcinoma, Renal Cell / Q000209:etiology* / Q000473:pathology / Q000556:secondary*; D017809:Fatal Outcome; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007680:Kidney Neoplasms / Q000209:etiology* / Q000473:pathology*; D010535:Laparoscopy / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000000981:diagnostic imaging; D009392:Nephrectomy / Q000009:adverse effects*; D011183:Postoperative Complications; D013899:Thoracic Neoplasms / Q000473:pathology / Q000556:secondary; D014057:Tomography, X-Ray Computed