Retroperitoneal laparoscopic radical nephrectomy: intermediate oncological results.
OBJECTIVE
To report the intermediate oncological results of laparoscopic radical nephrectomy by retroperitoneal approach.


METHODS
From 1995 to 2006, 146 consecutive patients with removal of a malignant kidney tumor by laparoscopic retroperitoneal radical nephrectomy were analysed retrospectively. The patients were followed clinically, biologically and radiologically every 6 months. Disease-free survival and specific survival were determined among patients free of metastasis at surgery.


RESULTS
Patient's average age was 61.1 years (25-85). The pathology of these cancers were: 108 clear cell carcinomas, 26 papillary carcinomas, 10 chromophobe carcinomas, and 2 miscellaneous. The T stage were: 105 pT1, 12 pT2, and 29 pT3 (TNM 2002). The Fuhrman grade were: I in 23 cases, II in 70 cases, III in 40 cases, and IV in 9 cases. The surgical margins were positive in 2. No port site recurrence occurred. The average follow-up was 35.4 months (1-137). Five patients had metastatic disease at presentation. Tumor progression was observed among 19 patients, in the form of a local (1) or remote recurrence (18). Fourteen patients died, including 7 because of their tumor. The disease-free survival at 5 and 10 years, were respectively 87.3 and 73.2%, and the cancer-specific survival were 96.2 and 92.0%, respectively.


CONCLUSIONS
The laparoscopic retroperitoneal radical nephrectomy offers intermediate oncological results compatible with appropriate carcinological efficacy.
Larré
Stéphane
S
Department of Urology, Henri Mondor University Hospital, Créteil, France. stephane.larre@hmn.aphp.fr
Kanso
Chaker
C
De La Taille
Alexandre
A
Hoznek
Andras
A
Vordos
Dimitrios
D
Yiou
René
R
Abbou
Clément-Claude
CC
Salomon
Laurent
L
D018262:Adenocarcinoma, Clear Cell / Q000601:surgery*; D000328:Adult; D000368:Aged; D002291:Carcinoma, Papillary / Q000601:surgery; D002292:Carcinoma, Renal Cell / Q000601:surgery; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007680:Kidney Neoplasms / Q000601:surgery*; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy / Q000379:methods*; D011183:Postoperative Complications; D012187:Retroperitoneal Space / Q000601:surgery; D012189:Retrospective Studies; D016896:Treatment Outcome