Abstract
Objectives
To assess the impact of surgical approaches and clinico-pathological parameters on the prognosis of localized renal cell carcinoma (RCC) after laparoscopic radical nephrectomy (LRN) or open radical nephrectomy (ORN).
Methods
Between 2002 and 2008, 336 patients with localized RCC were treated at our two institutions. Of these, 261 were classified as clinical stage pT1 and 75 as pT2, the mean age was 52.3 years. One hundred forty-two patients underwent LRN, and 194 underwent ORN. The medical records of all patients were retrospectively reviewed.
Results
The mean follow-up was 44 months (12–84 months). The 3-, 5-, and 7-year cancer-specific survival (CSS) rates of LRN group (96.3, 94.6, and 92.5%, respectively) were equivalent to ORN (97.4, 94.2, and 91.4%, respectively). The mean CSS rates were not significantly different between LRN and ORN groups for either pT1 (82.3 vs. 81.6 months, P = 0.713) or pT2 (69.0 vs. 72.1 months, P = 0.729). Univariate analysis demonstrated significant impact of tumor stage (pT1 vs. pT2, P = 0.002) and tumor grade (G1/2 vs. G3/4, P = 0.045) on CSS. Surgical approach (laparoscopic or open) was not a statistically significant factor on CSS. Multivariate analysis identified that tumor stage was an independent prognostic factor for CSS of localized RCC (P = 0.007).
Conclusions
Based on the long-term follow-up, our evaluation suggests that LRN is oncologically equivalent to ORN for patients with pT1 or pT2 tumors. Among the clinical variables, tumor stage appears to be an independent prognostic factor of CSS of localized RCC patients.
Similar content being viewed by others
References
Clayman RV, Kavoussi LR, Soper NJ et al (1991) Laparoscopic nephrectomy: initial case report. J Urol 146:278–282
Cadeddu JA, Ono Y, Clayman RV et al (1998) Laparoscopic nephrectomy for renal cell cancer: evaluation of efficacy and safety: a multicenter experience. Urology 52:773–777
Wille AH, Roigas J, Deger S et al (2004) Laparoscopic radical nephrectomy: techniques, results and oncological outcome in 125 consecutive cases. Eur Urol 45:483–488
Goel A, Hemal AK, Gupta NP (2002) Retroperitoneal laparoscopic radical nephrectomy and nephroureterectomy and comparison with open surgery. World J Urol 20:219–223
Hemal AK, Kumar A, Gupta NP et al (2007) 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
Permpongkosol S, Chan DY, Link RE et al (2005) Long-term survival analysis after laparoscopic radical nephrectomy. J Urol 174:1222–1225
Larré S, Kanso C, De La Taille A et al (2008) Retroperitoneal laparoscopic radical nephrectomy: intermediate oncological results. World J Urol 26:611–615
Colombo JR Jr, Haber GP, Jelovsek JE et al (2008) Seven years after laparoscopic radical nephrectomy: oncologic and renal functional outcomes. Urology 71:1149–1154
Abbou CC, Cicco A, Gasman D et al (1999) Retroperitoneal laparoscopic versus open radical nephrectomy. J Urol 161:1776–1780
Dunn MD, Portis AJ, Shalhav AL et al (2000) Laparoscopic versus open radical nephrectomy: a 9-year experience. J Urol 164:1153–1159
Portis AJ, Yan Y, Landman J et al (2002) Long-term follow-up after laparoscopic radical nephrectomy. J Urol 167:1257–1262
Colombo JR Jr, Haber GP, Aron M et al (2007) Oncological outcomes of laparoscopic radical nephrectomy for renal cancer. Clinics 62:251–256
Hemal AK, Kumar A, Kumar R et al (2007) Laparoscopic versus open radical nephrectomy for large renal tumors: a long-term prospective comparison. J Urol 177:862–866
Lam JS, Belldegrun AS, Pantuck AJ (2006) Long-term outcomes of the surgical management of renal cell carcinoma. World J Urol 24:255–266
Medeiros LJ, Gelb AB, Weiss LM (1988) Renal cell carcinoma—prognostic significance of morphologic parameters in 121 cases. Cancer 61:1639–1651
Bretheau D, Lechevallier E, de Fromont M et al (1995) Prognostic value of nuclear grade of renal cell carcinoma. Cancer 76:2543–2549
Sobin LH, Wittekind Ch (1997) TNM classification of malignant tumours, 5th edn edn. Wiley-Liss, New York
Wittekind Ch, Meyer HJ, Bootz F (2002) TNM classification of malignant tumours, 6th edn edn. Springer, Berlin
Minervini R, Minervini A, Fontana N et al (2000) Evaluation of the 1997 tumor, nodes and metastases classification of renal cell carcinoma: experience in 172 patients. BJU Int 86:199–202
Bedke J, Pritsch M, Buse S et al (2008) Prognostic stratification of localized renal cell carcinoma by tumor size. J Urol 180:62–67
Zorn KC, Gong EM, Orvieto MA et al (2007) Comparison of laparoscopic radical and partial nephrectomy: effects on long-term serum creatinine. Urology 69:1035–1040
Thompson RH, Boorjian SA, Lohse CM et al (2008) Radical nephrectomy for pT1a renal masses may be associated with decreased overall survival compared with partial nephrectomy. J Urol 179:468–471
Acknowledgments
Grants from the Nature Science Foundation of Guangdong (06300794); and Guangdong Provincial Science and Technology Foundation (2008B030301112).
Conflict of interest statement
None declared.
Author information
Authors and Affiliations
Corresponding authors
Rights and permissions
About this article
Cite this article
Luo, JH., Zhou, FJ., Xie, D. et al. Analysis of long-term survival in patients with localized renal cell carcinoma: laparoscopic versus open radical nephrectomy. World J Urol 28, 289–293 (2010). https://doi.org/10.1007/s00345-009-0487-9
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00345-009-0487-9