Long-term oncological outcomes of laparoscopic partial nephrectomy.
OBJECTIVE
Widespread applicability of laparoscopic partial nephrectomy will only occur when oncologic outcomes are critically analyzed in the context of published open partial nephrectomy series. The most recent oncologic outcomes of laparoscopic partial nephrectomy are reviewed.


RESULTS
Oncologic outcomes at 5 years of follow-up have recently been published for laparoscopic partial nephrectomy. The low margin positivity demonstrated by earlier series has translated into cancer-specific survival rates comparable to open partial nephrectomy. Local and distant recurrence rates are acceptably low, and in line with both contemporary and historical open partial nephrectomy pT1 controls.


CONCLUSIONS
Laparoscopic partial nephrectomy is becoming a standard of care for selected small renal tumors at high volume centers. While the goal of minimizing morbidity is laudable, ultimately its effectiveness as a cancer operation is the most important criterion. At high volume centers, in expert hands this technically advanced procedure has been shown to duplicate the oncologic outcomes of open surgery. The indolent natural history of small renal masses mandates that we await 10-year data, as well as corroboration of these favorable results at multiple institutions.
Canes
David
D
Department of Urology, Section of Laparoscopic and Robotic Surgery, Cleveland Clinic Hospital, Cleveland, Ohio, USA. canesd@ccf.org
D006801:Humans; D007680:Kidney Neoplasms / Q000473:pathology / Q000601:surgery*; D010535:Laparoscopy; D009392:Nephrectomy / Q000379:methods*