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

被引:28
作者
Hemal, Ashok K. [1 ]
Kumar, Anup [1 ]
Gupta, Narmada P. [1 ]
Kumar, Rajeev [1 ]
机构
[1] All India Inst Med Sci, Dept Urol, New Delhi 110029, India
关键词
kidney; carcinoma; laparoscopy; nephrectomy;
D O I
10.1007/s00345-007-0210-7
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
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 (T I -2N0M0) provides satisfactory short and long-term oncologic efficacy.
引用
收藏
页码:619 / 626
页数:8
相关论文
共 30 条
[11]  
2-W
[12]   Laparoscopic radical nephrectomy: Comparison of clinical Stage T1 and T2 renal tumors [J].
Gong, Edward M. ;
Lyon, Mark B. ;
Orvieto, Marcelo A. ;
Lucioni, Alvaro ;
Gerber, Glenn S. ;
Shalhav, Arieh L. .
UROLOGY, 2006, 68 (06) :1183-1187
[13]  
Guinan P, 1997, CANCER, V80, P992, DOI 10.1002/(SICI)1097-0142(19970901)80:5<992::AID-CNCR26>3.0.CO
[14]  
2-Q
[15]   Laparoscopic versus open radical nephrectomy for large renal tumors: A long-term prospective comparison [J].
Hemal, A. K. ;
Kumar, A. ;
Kumar, R. ;
Wadhwa, P. ;
Seth, A. ;
Gupta, N. P. .
JOURNAL OF UROLOGY, 2007, 177 (03) :862-866
[16]   Laparoscopic nephrectomy: Assessment of morcellation versus intact specimen extraction on postoperative status [J].
Hernandez, F ;
Rha, KH ;
Pinto, PA ;
Kim, FJ ;
Klicos, N ;
Chan, TY ;
Kavoussi, LR ;
Jarrett, TW .
JOURNAL OF UROLOGY, 2003, 170 (02) :412-415
[17]   Impact of lymphadenectomy and nodal burden in renal cell carcinoma: Retrospective analysis of the national surveillance, epidemiology, and end results database [J].
Joslyn, SA ;
Sirintrapun, SJ ;
Konety, BR .
UROLOGY, 2005, 65 (04) :675-680
[18]   Long-term outcomes of the surgical management of renal cell carcinoma [J].
Lam, John S. ;
Belldegrun, Arie S. ;
Pantuck, Allan J. .
WORLD JOURNAL OF UROLOGY, 2006, 24 (03) :255-266
[19]   Expanding the indications for laparoscopic radical nephrectomy [J].
Mattar, Kamal ;
Finelli, Antonio .
CURRENT OPINION IN UROLOGY, 2007, 17 (02) :88-92
[20]   Tumor seeding in urological laparoscopy: An international survey [J].
Micali, S ;
Celia, A ;
Bove, P ;
De Stefani, S ;
Sighinolfi, MC ;
Kavoussi, LR ;
Bianchi, G .
JOURNAL OF UROLOGY, 2004, 171 (06) :2151-2154