Long-term oncologic outcomes of laparoscopic versus open partial nephrectomy.
BACKGROUND
Most of the literatures on laparoscopic partial nephrectomy (LPN) versus open partial nephrectomy (OPN) focus on technical details and early or mid-term oncologic outcomes, reflecting that the approach is safe and provides midterm benefits compared with traditional open surgery. However, the difference of long-term oncologic outcome between LPN and OPN remains unclear. The aim of this meta-analysis was to evaluate the long-term oncologic outcome of LPN in the treatment of localized renal tumors compared with that of OPN.


METHODS
A systematic search of electronic databases including Medline, Embase, and Cochrane library was conducted. Comparative studies reporting on long-term oncologic outcome of LPN versus OPN were regarded eligible. The odds ratio (OR) and its corresponding 95% confidence intervals (CI) were calculated for the oncologic outcomes. The methodologic quality of the included studies was evaluated using the strict criteria of the Newcastle-Ottawa scale.


RESULTS
Six comparative studies (1495 participants including 555 LPN and 940 OPN) were included in the present study. There was no significant difference between LPN and OPN in 5-year overall survival (OS) rates (OR = 1.83, 95% CI (0.80, 4.19)), 5-year cancer specific survival (CSS) rates (OR = 1.09, 95% CI (0.62, 1.92)), and 5-year recurrence free survival (RFS) rates (OR = 0.68, 95% CI (0.37, 1.26)).


CONCLUSIONS
The results of this meta-analysis revealed that there was no significant difference in long-term oncologic outcome between LPN and OPN for treatment of localized renal tumors.
Department of Urology, Shanghai Tenth People's Hospital, Tongji University, Shanghai 200072, China. zhengjh0471@sina.com
Jun-hua
JH
Zheng
Xiao-long
XL
Zhang
Jiang
J
Geng
Chang-cheng
CC
Guo
Xiao-peng
XP
Zhang
Jian-ping
JP
Che
Yang
Y
Yan
Bo
B
Peng
Guang-chun
GC
Wang
Sheng-qiang
SQ
Xia
Yan
Y
Wu
D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000601:surgery*; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy / Q000379:methods*; D015996:Survival Rate; D016896:Treatment Outcome