title: Long-term outcome of hand-assisted laparoscopic radical nephrectomy for T1 renal cell carcinoma.
abstract: OBJECTIVE
  To investigate the long-term outcomes of hand-assisted laparoscopic radical nephrectomy compared with those of open nephrectomy.
  
  
  METHODS
  Hand-assisted laparoscopic radical nephrectomy was carried out in 132 patients with T1 renal cell carcinoma (between November 1999 and November 2008). Their outcomes were compared with those of 61 patients treated with open nephrectomy. The durations of follow up were 6-121 months (median 65 months) and 7-146 months (median 84 months) in the hand-assisted laparoscopic radical nephrectomy and open nephrectomy groups, respectively.
  
  
  RESULTS
  The 7-year recurrence-free rates were 88.5 and 85.6% in the hand-assisted laparoscopic radical nephrectomy and open nephrectomy groups, respectively, showing no significant difference between the two groups. The 7-year cancer-specific survival rates were 92.3 and 91.4% in the hand-assisted laparoscopic radical nephrectomy and open nephrectomy groups, respectively, showing no significant difference between the two groups. Also, the 10-year recurrence-free rates were 85.4 and 78.1% in the hand-assisted laparoscopic radical nephrectomy and open nephrectomy groups, respectively. When changes in the recurrence-free rate were analyzed using the Kaplan-Meier method, no significant difference was observed between the two groups. The 10-year cancer-specific survival rates were 91.8 and 87.9% for hand-assisted laparoscopic radical nephrectomy and open nephrectomy, respectively, showing no significant difference between the groups.
  
  
  CONCLUSIONS
  Hand-assisted laparoscopic radical nephrectomy might be comparable with open nephrectomy with regard to long-term cancer control.
authors.affiliation: Department of Urology, Kyoto Prefectural University of Medicine, Kyoto, Japan.
authors.forename: Fumiya
authors.initials: F
authors.lastname: Hongo
authors.forename: Akihiro
authors.initials: A
authors.lastname: Kawauchi
authors.forename: Takashi
authors.initials: T
authors.lastname: Ueda
authors.forename: Atsuko
authors.initials: A
authors.lastname: Fujihara
authors.forename: Yasuyuki
authors.initials: Y
authors.lastname: Naitoh
authors.forename: Terukazu
authors.initials: T
authors.lastname: Nakamura
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Naya
authors.forename: Kazumi
authors.initials: K
authors.lastname: Kamoi
authors.forename: Koji
authors.initials: K
authors.lastname: Okihara
authors.forename: Tsuneharu
authors.initials: T
authors.lastname: Miki
mesh_terms: D000368:Aged; D002292:Carcinoma, Renal Cell / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007680:Kidney Neoplasms / Q000601:surgery*; D010535:Laparoscopy / Q000706:statistics & numerical data*; D007813:Laparotomy / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D016896:Treatment Outcome
keywords: hand-assisted method; laparoscopic surgery; long-term outcome; renal cell carcinoma