Oncologic Outcomes After Laparoscopic Partial Nephrectomy: Mid-Term Results

Abstract

To describe the oncologic outcomes of renal cell carcinoma (RCC) diagnosed in patients and submitted to laparoscopic partial nephrectomy (LPN) in a laparoscopic referral center. We retrospectively analyzed data of 150 consecutive patients with small renal masses and treated with LPN between 2000 and 2010 at a laparoscopic referral center. Pathologic RCC was diagnosed in 137 patients and were included in the oncologic outcome analysis. Kaplan-Meyer methods were used to estimate the probability of disease recurrence and cancer-specific survival. Median follow-up for patients without recurrence was 38 months (interquartile range [IQR] 19-70). The majority of the patients (88%) were found to have pT1a disease at the final pathology report; eight patients (6%) were classified as pT3a. The median tumor size was 25 mm (IQR 20-32). Clear cell type histology was found in 97 patients (66%); most of the patients had Fuhrman grade 2 (72%) or 3 (21%). The 2- and 5-year recurrence-free survival rates were 98% and 95%, respectively. The positive surgical margin was found in 1.4% of the patients. The 2-year and 5-year CSS rates were 99% and 97%, respectively. Kaplan-Meyer methods showed that patients with pT3a were more likely to experience disease recurrence and patients with Fuhrman grade 3 to die of the disease. LPN seems to provide excellent cancer control rates and to be an oncologically feasible and safe option for treating patients with small renal masses. Recurrence and death from the disease are extremely uncommon and mostly related to a higher pathologic stage or Fuhrman grade, but not positive surgical margins.