5-Year outcomes of laparoscopic partial nephrectomy

• Published in: The Journal of urology Vol. 177; no. 1; p. 70
• Main Authors: Lane, Brian R, Gill, Inderbir S
• Format: Journal Article
• Language: English
• Published: United States 01-01-2007
• Subjects: Adult; Aged; Aged, 80 and over; Carcinoma, Renal Cell - surgery; Female; Follow-Up Studies; Humans; Kidney Neoplasms - surgery; Laparoscopy; Male; Middle Aged; Nephrectomy - methods; Time Factors; Treatment Outcome
• ISSN: 0022-5347
• DOI: 10.1016/j.juro.2006.08.093

Laparoscopic partial nephrectomy is increasingly a definitive therapeutic option in patients with a small renal mass. Intermediate term oncological outcomes after laparoscopic partial nephrectomy are excellent up to a mean followup of 3 years. We present outcomes in 56 patients, each of whom has now completed a minimum of 5 years of followup after laparoscopic partial nephrectomy.
Of the 557 laparoscopic partial nephrectomies performed at our institution 58 patients with a localized tumor have completed more than 5 years since surgery. Clinical and renal functional data on 56 patients (97%) were obtained from medical records, radiographic reports and patient contact via telephone.
Average patient age was 64 years and 9% were symptomatic at presentation. Average tumor size was 2.9 cm. On histopathology renal cell carcinoma was confirmed in 37 cases (66%) and pathological tumor stage was pT1a in 32 (86%). Final surgical margin was positive for cancer in 1 patient. Median serum creatinine preoperatively and postoperatively was 0.9 and 1.0 mg/dl, respectively. No patient with normal baseline serum creatinine undergoing elective laparoscopic partial nephrectomy had postoperative chronic renal insufficiency (serum creatinine more than 2 mg/dl). At a median followup of 5.7 years (range 5.0 to 6.9) no distant recurrence (0%) and a single local recurrence (2.7%) were detected. Overall and cancer specific survival was 86% and 100%, respectively, at 5 years.
To our knowledge this is the initial report in the literature of oncological and renal functional outcomes 5 years after laparoscopic partial nephrectomy with excellent results comparable to those of open nephron sparing surgery. At our center laparoscopic partial nephrectomy is an established alternative to open partial nephrectomy.