title: A Multicentered, Propensity Matched Analysis Comparing Laparoscopic and Open Surgery for pT3a Renal Cell Carcinoma.
abstract: To compare outcomes following laparoscopic renal surgery (LRS) and open renal surgery (ORS) in the treatment of pathologic T3a (pT3a) renal cell carcinoma (RCC) using a propensity matched analysis.
  
  
  
  The Canadian Kidney Cancer Information System is a prospectively maintained database for patients diagnosed with RCC from 15 Canadian institutions. Patients treated for nonmetastatic pT3a RCC between 2008 and 2015 were included. Propensity score matching for age, gender, tumor size, grade, histology, and surgical approach was performed to compare laparoscopic radical and partial nephrectomy (LRN or LPN) with open radical or partial nephrectomy (ORN or OPN). The primary endpoint was recurrence-free survival (RFS).
  
  
  
  Two hundred twenty-six (45%) patients underwent LRS (88% LRN and 12% LPN), and 275 (55%) underwent ORS (75% ORN and 25% OPN). After a median follow-up of 21.1 months, 155 (72 LRS and 83 ORS) patients experienced recurrence. The 3-year RFS was 63% and 50% for the LRS and ORS groups, respectively, p = 0.36. On subgroup analysis, there was no significant difference in RFS among patients who underwent radical nephrectomy (3-year RFS 61% in LRN compared with 46% in ORN group, p = 0.32) or partial nephrectomy (77% in LPN compared with 79% in OPN group, p = 0.82).
  
  
  
  This study is the largest matched analysis comparing LRS and ORS for pT3a RCC. In matched patients, LRS showed no difference in oncologic outcomes compared with ORS and should be considered when technically feasible.
authors.affiliation: 1 Section of Urology, University of Manitoba , Winnipeg, Canada .
authors.forename: Premal
authors.initials: P
authors.lastname: Patel
authors.affiliation: 1 Section of Urology, University of Manitoba , Winnipeg, Canada .
authors.forename: Jasmir G
authors.initials: JG
authors.lastname: Nayak
authors.affiliation: 2 Cancer Care Ontario , Toronto, Canada .
authors.forename: Zhihui
authors.initials: Z
authors.lastname: Liu
authors.affiliation: 3 Dalla Lana School of Public Health, University of Toronto , Toronto, Canada .
authors.forename: Olli
authors.initials: O
authors.lastname: Saarela
authors.affiliation: 4 Division of Urology, University of Toronto , Toronto, Canada .
authors.forename: Michael
authors.initials: M
authors.lastname: Jewett
authors.affiliation: 5 Department of Urology, Dalhousie University , Halifax, Canada .
authors.forename: Ricardo
authors.initials: R
authors.lastname: Rendon
authors.affiliation: 6 Division of Urology, McMaster University , Hamilton, Canada .
authors.forename: Anil
authors.initials: A
authors.lastname: Kapoor
authors.affiliation: 7 Department of Urologic Sciences, University of British Columbia , Vancouver, Canada .
authors.forename: Peter
authors.initials: P
authors.lastname: Black
authors.affiliation: 8 Division of Urology, McGill University , Montreal, Canada .
authors.forename: Simon
authors.initials: S
authors.lastname: Tanguay
authors.affiliation: 9 Southern Alberta Institute of Urology, University of Calgary , Calgary, Canada .
authors.forename: Jun
authors.initials: J
authors.lastname: Kawakami
authors.affiliation: 10 Division of Urology, University of Alberta , Edmonton, Canada .
authors.forename: Ronald
authors.initials: R
authors.lastname: Moore
authors.affiliation: 11 Division of Urology, The Ottawa Hospital Research Institute, University of Ottawa , Ottawa, Canada .
authors.forename: Rodney H
authors.initials: RH
authors.lastname: Breau
authors.affiliation: 11 Division of Urology, The Ottawa Hospital Research Institute, University of Ottawa , Ottawa, Canada .
authors.forename: Chris
authors.initials: C
authors.lastname: Morash
authors.affiliation: 12 Centre Hospitalier Universitaire de Québec , Quebec City, Canada .
authors.forename: Frédéric
authors.initials: F
authors.lastname: Pouliot
authors.affiliation: 1 Section of Urology, University of Manitoba , Winnipeg, Canada .
authors.forename: Darrel E
authors.initials: DE
authors.lastname: Drachenberg
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002170:Canada; D002292:Carcinoma, Renal Cell / Q000473:pathology / Q000601:surgery*; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000473:pathology / Q000601:surgery*; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D009392:Nephrectomy / Q000379:methods*; D057216:Propensity Score; D011446:Prospective Studies; D055815:Young Adult
keywords: laparoscopic renal surgery; multicentered; open renal surgery; pT3 renal cell carcinoma; propensity matched