title: Survival of patients with nonmetastatic pT3 renal tumours: a matched comparison of laparoscopic vs open radical nephrectomy.
abstract: OBJECTIVE
  To compare the oncological outcome of patients with pT3 renal tumours treated either by laparoscopic radical nephrectomy (LRN) or open RN (ORN).
  
  
  METHODS
  In a retrospective review of a multi-institutional database, we identified 1003 patients with a T3N0M0 renal tumour and with no vena caval invasion. Sixty-five patients treated by LRN were matched with up to four patients treated by ORN. Exact matches were made for age, gender, tumour size, perirenal fat invasion, renal vein invasion, and histological subtype. Following the matching process there were 44 patients treated by LRN and 135 by ORN. Qualitative and continuous variables were compared using chi-square and independent-sample t-tests, respectively. Differences in survival were compared using the Kaplan-Meier method. A Cox regression model was used to test the effect of variables on survival.
  
  
  RESULTS
  The two groups were comparable for age (P = 0.4), gender, tumour size (P = 0.4), tumour grade (P = 0.25) and histological subtype (P = 0.45). The mean follow-up was longer in the ORN group (55 vs 28 months, P < 0.001). There was no difference in survival between the ORN and LRN groups in the whole T3 population (P = 0.7), in those with perirenal fat invasion (P = 0.9), or in the subset with renal vein invasion (P = 0.31). In univariate analysis, the only predictor for death from cancer was tumour grade (P = 0.05). In multivariate analysis, no variable was significantly associated with cancer survival.
  
  
  CONCLUSIONS
  LRN has no adverse effect on cancer survival compared to ORN in patients with microscopic T3 renal cancer. Additional prospective evaluation is warranted.
authors.affiliation: Department of Urology, Mondor Hospital, Paris, France. karim.bensalah@chu-rennes.fr
authors.forename: Karim
authors.initials: K
authors.lastname: Bensalah
authors.forename: Laurent
authors.initials: L
authors.lastname: Salomon
authors.forename: Herve
authors.initials: H
authors.lastname: Lang
authors.forename: Laurent
authors.initials: L
authors.lastname: Zini
authors.forename: Didier
authors.initials: D
authors.lastname: Jacqmin
authors.forename: Andrea
authors.initials: A
authors.lastname: Manunta
authors.forename: Maxime
authors.initials: M
authors.lastname: Crepel
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Ficarra
authors.forename: Luca
authors.initials: L
authors.lastname: Cindolo
authors.forename: Alexandre
authors.initials: A
authors.lastname: de La Taille
authors.forename: Pierre
authors.initials: P
authors.lastname: Karakiewicz
authors.forename: Jean-Jacques
authors.initials: JJ
authors.lastname: Patard
mesh_terms: D000368:Aged; D002292:Carcinoma, Renal Cell / Q000401:mortality / Q000601:surgery*; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000401:mortality / Q000556:secondary / Q000601:surgery*; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy / Q000379:methods*; D016896:Treatment Outcome