Article - Comment

Laparoscopic versus open partial nephrectomy for the treatment of pathological T1N0M0 renal cell carcinoma: a 5-year survival rate

  • Yildirim Bayazit

Bull Urooncol 2006;5(4):31-33

Purpose: In this retrospective study, the oncological adequacy of laparoscopic partial nephrectomy is compared to that of open partial nephrectomy in the treatment of pT1N0M0 renal cell carcinoma. Materials and Methods: The study evaluates a total of 143 patients with pathologically confirmed T1N0M0 renal tumors who underwent partial nephrectomy between January 1996 - June 2004 and with a minimum 1.5 years followup. Laparoscopic partial nephrectomy was performed on 85 patients and open partial nephrectomy was performed on 58 patients. Medical and operative records with emphasis on tumor recurrence and survival were reviewed. Kaplan-Meier analysis was performed for statistical analysis. Results: In the laparoscopy group, 83 patients survived and mean followup was 40.4±18.0 months. Two patients had disease recurrence, one died of brain metastasis and one died of an unrelated cause. Port site metastasis was not observed. For the laparoscopy group, the 5-year disease-free and actuarial survival rates were 91.4%, and 93.8%, respectively. In the open surgery group, 53 patients survived and mean followup was 49.68±2- 8.84 months. One patient survived with recurrence and one with metastasis. Three patients died of unrelated causes. The 5-year diesase-free and patient survival rates in open surgery group were 97.6% and 95.8%, respectively. Statistical analyses for disease- free survival and patient survival revealed no significant differences between the two groups. Conclusions: In terms of mid-range oncological results, laparoscopic partial nephrectomy is an alternative technique comparable to open partial nephrectomy in patients with pathological stage T1N0M0 renal cell carcinoma.