Laparoscopic radical nephrectomy for renal cell carcinoma: oncological outcomes at 10 years or more.
OBJECTIVE
We present oncological outcomes at a followup of 10 years or greater after laparoscopic radical nephrectomy for cancer.


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.
Berger
Andre
A
USC Institute of Urology, Keck School of Medicine, University of Southern California, Los Angeles, California 90080, USA.
Brandina
Ricardo
R
Atalla
Mohamed A
MA
Herati
Amin S
AS
Kamoi
Kazumi
K
Aron
Monish
M
Haber
Georges-Pascal
GP
Stein
Robert J
RJ
Desai
Mihir M
MM
Kavoussi
Louis R
LR
Gill
Inderbir S
IS
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002292:Carcinoma, Renal Cell / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007680:Kidney Neoplasms / Q000601:surgery*; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy / Q000379:methods*; D013997:Time Factors; D016896:Treatment Outcome