Skip to main content

Advertisement

Log in

Oncologic outcome of 132 cases of laparoscopic radical nephrectomy with intact specimen removal for T1-2N0M0 renal cell carcinoma

  • Original Article
  • Published:
World Journal of Urology Aims and scope Submit manuscript

Abstract

We present the short and long-term oncologic outcome of 132 patients with pathologically confirmed T1–T2, N0M0 renal cell carcinoma (RCC), who underwent laparoscopic radical nephrectomy with intact specimen removal at our institution. Beginning January 1998, we prospectively collected data of 132 patients undergoing laparoscopic radical nephrectomy, whose final pathologic stage was T1 or T2, N0M0, RCC. The clinical data of three groups categorized as group (pT1a)—36 patients, group (pT1b)—51 patients and group (pT2)—45 patients were analyzed statistically to assess oncological outcome. The specimens were removed intact without morcellation in all patients in a homemade plastic bag. The total median follow-up was 56 months (range 3–80 months) and there were no local or port-site recurrences or hernia. Patients with pT2 tumors had significantly greater operating time, blood loss and analgesic requirements than pT1a/pT1b tumor patients. The distant metastases were found in 1, 4 and 5 patients in group pT1a, pT1b and pT2, respectively. The 5-year cancer-specific survival was 97.2, 86.3 and 82.2%, respectively, in pT1a, pT1b and pT2 tumor patients (significantly lower in pT2 than pT1a, P = 0.008). The 5-year recurrence-free survival was 97.2, 84.3 and 82.2%, respectively, in pT1a, pT1b and pT2 tumor patients (significantly lower in pT2 than pT1a, P = 0.02). Laparoscopic radical nephrectomy (retroperitoneal and transperitoneal route) with intact specimen removal for localized renal cell carcinoma (T1-2N0M0) provides satisfactory short and long-term oncologic efficacy.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Chan D, Cadeddu JA, Jarrett TW, Marshall F, Kavoussi LR (2001) Laparoscopic radical nephrectomy: cancer control for renal cell carcinoma. J Urol 166:2095–2100

    Article  PubMed  CAS  Google Scholar 

  2. Gill IS, Meraney AM, Schweizer DK et al (2001) Laparoscopic radical nephrectomy in 100 patients: a single center experience from the United States. Cancer 92:1843–1855

    Article  PubMed  CAS  Google Scholar 

  3. Ono Y, Kinukawa T, Hattori R et al (1999) Laparoscopic radical nephrectomy for renal cell carcinoma: a five-year experience. Urology 53:280–286

    Article  PubMed  CAS  Google Scholar 

  4. Deane LA, Clayman RV (2007) Laparoscopic nephrectomy for renal cell cancer: radical and total. BJU Int 99(5 Pt B):1251–1257

    Article  PubMed  Google Scholar 

  5. Mattar K, Finelli A (2007) Expanding the indications for laparoscopic radical nephrectomy. Curr Opin Urol 17(2):88–92

    Article  PubMed  Google Scholar 

  6. Steinberg AP, Finelli A, Desai MM, Abreu SC, Ramani AP, Spaliviero M et al (2004) Laparoscopic radical nephrectomy for large (greater than 7 cm, T2) renal tumors. J Urol 172:2172–2176

    Article  PubMed  Google Scholar 

  7. Portis AJ, Yan Y, Landman J, Chen C, Barrett PH, Fentie DD et al (2002) Long-term follow-up after laparoscopic radical nephrectomy. J Urol 167:1257–1262

    Article  PubMed  Google Scholar 

  8. Gong EM, Lyon MB, Orvieto MA, Lucioni A, Gerber GS, Shalhav AL (2006) Laparoscopic radical nephrectomy: comparison of clinical Stage T1 and T2 renal tumors. Urology 68(6):1183–1187

    Article  PubMed  Google Scholar 

  9. Permpongkosol S, Chan DY, Link RE, Sroka M, Allaf M, Varkarakis I et al (2005) Long-term survival analysis after laparoscopic radical nephrectomy. J Urol 174:1222–1225

    Article  PubMed  Google Scholar 

  10. Cheung MC, Lee YM, Rindani R, Lau H (2005) Oncological outcome of 100 laparoscopic radical nephrectomies for clinically localized renal cell carcinoma. ANZ J Surg 75:593–596

    Article  PubMed  Google Scholar 

  11. Lam JS, Belldegrun AS, Pantuck AJ (2006) Long-term outcomes of the surgical management of renal cell carcinoma. World J Urol 24(3):255–266

    Article  PubMed  Google Scholar 

  12. Clayman RV, Kavoussi LR, Soper NJ, Dierks SM, Meretyk S, Darcy MD et al (1991) Laparoscopic nephrectomy: initial case report. J Urol 146:278–282

    PubMed  CAS  Google Scholar 

  13. Guinan P, Sobin LH, Algaba F, Badellino F, Kameyama S, MacLennan G et al (1997) TNM staging of renal cell carcinoma: Workgroup No. 3. Union International Contre le Cancer (UICC) and the American Joint Committee on Cancer (AJCC). Cancer 80:992–993

    Article  PubMed  CAS  Google Scholar 

  14. Hemal AK, Kumar A, Kumar R, Wadhwa P, Seth A, Gupta NP (2007) Laparoscopic versus open radical nephrectomy for large renal tumors: a long-term prospective comparison. J Urol 177(3):862–866

    Article  PubMed  CAS  Google Scholar 

  15. Steiner T, Knels R, Schubert J (2004) Prognostic significance of tumour size in patients after tumour nephrectomy for localised renal cell carcinoma. Eur Urol 46:327–330

    Article  PubMed  Google Scholar 

  16. Hernandez F, Rha KH, Pinto PA, Kim FJ, Klicos N, Chan TY et al (2003) Laparoscopic nephrectomy: assessment of morcellation versus intact specimen extraction on postoperative status. J Urol 170:412–415

    Article  PubMed  Google Scholar 

  17. Catalano C, Fraioli F, Laghi A, Napoli A, Pediconi F, Danti M et al (2003) High-resolution multidetector CT in the preoperative evaluation of patients with renal cell carcinoma. Am J Roentgenol 180:1271–1277

    CAS  Google Scholar 

  18. Cohen DD, Matin SF, Steinberg JR, Zagone R, Wood CG (2005) Evaluation of the intact specimen after laparoscopic radical nephrectomy for clinically localized renal cell carcinoma identifies a subset of patients at increased risk for recurrence. J Urol 173(5):1487–1490

    Article  PubMed  Google Scholar 

  19. Varkarakis I, Rha K, Hernandez F, Kavoussi LR, Jarrett TW (2005) Laparoscopic specimen extraction: morcellation. BJU Int 95(Suppl 2):27–31

    Article  PubMed  Google Scholar 

  20. Dunn MD, Portis AJ, Shalhav AL, Elbahnasy AM, Heidorn C, McDougall EM, Clayman RV (2000) Laparoscopic versus open radical nephrectomy: a 9 year experience. J Urol 164(4):1153–1159

    Article  PubMed  CAS  Google Scholar 

  21. Yaycioglu O, Roberts WW, Chan T, Epstein JI, Marshall FF, Kavoussi LR (2001) Prognostic assessment of non-metastatic renal cell carcinoma: a clinically based model. Urol 58(2):141–145

    Article  PubMed  CAS  Google Scholar 

  22. Phillips CK, Taneja SS (2004) The role of lymphadenectomy in the surgical management of renal cell carcinoma. Urol Oncol 22:214–223

    PubMed  Google Scholar 

  23. Blom JH, van Poppel H, Marechal JM, Jacqmin D, Sylvester R, Schroder FH et al (1999) Radical nephrectomy with and without lymph node dissection: preliminary results of the EORTC randomized phase III protocol 30881. EORTC Genitourinary Group. Eur Urol 36:570–575

    Article  PubMed  CAS  Google Scholar 

  24. Joslyn SA, Sirintrapun SJ, Konety BR (2005) Impact of lymphadenectomy and nodal burden in renal cell carcinoma: retrospective analysis of the National Surveillance, Epidemiology, and End Results database. Urology 65:675–680

    Article  PubMed  Google Scholar 

  25. Rassweiler J, Tsivian A, Kumar AV, Lymberakis C, Schulze M, Seeman O et al (2003) Oncological safety of laparoscopic surgery for urological malignancy: experience with more than 1,000 operations. J Urol 169:2072–2075

    Article  PubMed  Google Scholar 

  26. Micali S, Celia A, Bove P, De Stefani S, Sighinolfi MC, Kavoussi LR et al (2004) Tumor seeding in urological laparoscopy: an international survey. J Urol 171:2151–2154

    Article  PubMed  CAS  Google Scholar 

  27. Saika T, Ono Y, Hattori R et al (2003) Long term outcome laparoscopic radical nephrectomy for pathological T1 renal cell carcinoma. Urology 62:1018–1023

    Article  PubMed  Google Scholar 

  28. Ficarra V, Novara G, Galfano A, Novella G, Schiavone D, Artibani W (2004) Application of TNM, 2002 version, in localized renal cell carcinoma: is it able to predict different cancer-specific survival probability? Urology 63:1050–1054

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Ashok K. Hemal.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Hemal, A.K., Kumar, A., Gupta, N.P. et al. Oncologic outcome of 132 cases of laparoscopic radical nephrectomy with intact specimen removal for T1-2N0M0 renal cell carcinoma. World J Urol 25, 619–626 (2007). https://doi.org/10.1007/s00345-007-0210-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00345-007-0210-7

Keywords

Navigation