We compare oncologic outcomes of minimally invasive and open nephrectomy for locally advanced kidney cancer.
A retrospective review of a single-institutional, prospectively maintained database from a National Comprehensive Cancer Network designated center was conducted. All patients who underwent radical nephrectomy at Roswell Park Cancer Institute with diagnosis of pT3 and pT4 renal cell carcinoma between years 1998 and 2015 were reviewed. Patients who underwent partial nephrectomy and nephroureterectomy were excluded.
We identified 172 patients with pT3 or pT4 tumors resected by minimally invasive (laparoscopic and robotic) or open radical nephrectomy. Demographic characteristics were similar between the two groups. Patients in the minimally invasive group had higher mean body mass index (31.9 vs 28.1, p=0.002), radiologically smaller tumors (7.7 cm vs 9.1 cm, p=0.008), lower mean estimated blood loss (277 vs 1429 p<0.001), lower rate of blood transfusion (4.7% vs 45.5%, p<0.001), and a shorter mean length of stay (3.5 vs 5.7 days, p<0.001) compared to patients who underwent open surgery. At a median follow-up of 32.8 months, there was no significant difference in overall survival (p=0.8) between the two groups.
Minimal invasive nephrectomy is a safe approach with similar oncological outcomes to open nephrectomy for select patients with locally advanced renal cell carcinoma.
Journal of endourology / Endourological Society. 2016 May 20 [Epub ahead of print]
Luciano Nunez Bragayrac, Daniel Abbotoy, Kristopher Attwood, Fadi Darwiche, Jan Hoffmeyer, Eric Kauffman, Thomas Schwaab
Roswell Park Cancer Institute, 2074, Urology, Buffalo, New York, United States ; ., Roswell Park Cancer Institute, 2074, Urology, Buffalo, New York, United States ; ., Roswell Park Cancer Institute, 2074, Biostatics & Bioinformatics, Buffalo, New York, United States ; ., Roswell Park Cancer Institute, 2074, Buffalo, New York, United States ; ., Otto von Guericke Universitat Magdeburg, 9376, Magdeburg, Sachsen-Anhalt, Germany ; ., Roswell Park Cancer Institute, Urology, Buffalo, New York, United States ; ., Roswell Park Cancer Institute, Buffalo, NY, Urology , Elm&Carlton Street , Buffalo, New York, United States , 14623 ; .