Comparison of laparoscopic versus open radical nephrectomy for large renal tumors: A retrospective analysis of multi-center results

Seung Hyun Jeon, Tae Gyun Kwon, Koon Ho Rha, Gyung Tak Sung, Wan Lee, Jae Sung Lim, Young Beom Jeong, Sung Hoo Hong, Hyeon Hoe Kim, Seok Soo Byun

Research output: Contribution to journalArticle

40 Citations (Scopus)

Abstract

Study Type - Therapy (case series) Level of Evidence 4 What's known on the subject? and What does the study add? While laparoscopic radical nephrectomy (LRN) has been confirmed in various studies to be at least as efficacious as open radical nephrectomy (ORN) in terms of oncological control and more advantageous from the perspective of minimal invasiveness, very few studies have examined its feasibility and efficacy when applied to renal masses exceeding 7 cm in size, and even fewer involved results obtained from multicentre investigations. The present study retrospectively reviewed the outcome of LRN for masses exceeding 7 cm in size carried out in 26 institutions between 2000 and 2007 and concluded that LRN offers results comparable to ORN in terms of both tumour control and procedure-associated morbidities. Furthermore, details from the study suggest that while the size of renal mass that can be treated using LRN may not be a necessarily limiting factor, the experience of the laparoscopic surgeon is a primary determinant in the overall outcome. OBJECTIVE To assess the feasibility and oncologic efficacy of laparoscopic radical nephrectomy (LRN) compared with open radical nephrectomy (ORN) in patients with large renal cell carcinomas (RCCs) >7 cm in size. PATIENTS AND METHODS We analysed the data from 255 patients who underwent radical nephrectomies at 26 institutions in Korea between January 2000 and December 2007 for RCCs > 7 cm in size. Eighty-eight patients who underwent LRNs were compared with 167 patients who underwent ORNs. The patients with tumor thrombi in the renal vein or IVC, and lymph node or distant metastases were excluded. We compared the operative time, estimated blood loss, complication rates, and 2-year overall and disease-free survival rates between the LRN and ORN groups. RESULTS The median duration of postoperative follow-up was 19 months for the LRN group and 25.8 months for the ORN group. The operative time was significantly longer in the LRN group than in the ORN group (241.5 ± 74.8 min vs 202.7 ± 69.6 min, P < 0.001) and blood loss was significantly lower in the LRN group than in the ORN group (439.8 ± 326.8 mL vs 604.4 ± 531.4 mL, P = 0.006). No statistically significant difference was found in complication rates, the 2-year overall (92.7% vs 94%, P = 0.586) and disease-specific (90.1% vs 93.7%, P = 0.314) survival rates between the LRN and ORN groups. CONCLUSIONS Despite the longer operative time, LRN was an effective and less invasive treatment option for clinical T2 renal tumors. It achieved a degree of cancer control similar to that obtained with ORN.

Original languageEnglish
Pages (from-to)817-821
Number of pages5
JournalBJU International
Volume107
Issue number5
DOIs
Publication statusPublished - 2011 Mar 1

Fingerprint

Nephrectomy
Kidney
Neoplasms
Operative Time
Renal Cell Carcinoma
Survival Rate
Large Cell Carcinoma
Renal Veins

All Science Journal Classification (ASJC) codes

  • Urology

Cite this

Jeon, Seung Hyun ; Kwon, Tae Gyun ; Rha, Koon Ho ; Sung, Gyung Tak ; Lee, Wan ; Lim, Jae Sung ; Jeong, Young Beom ; Hong, Sung Hoo ; Kim, Hyeon Hoe ; Byun, Seok Soo. / Comparison of laparoscopic versus open radical nephrectomy for large renal tumors : A retrospective analysis of multi-center results. In: BJU International. 2011 ; Vol. 107, No. 5. pp. 817-821.
@article{f59fbd2b46ac499a99cc0aa12f61e8cc,
title = "Comparison of laparoscopic versus open radical nephrectomy for large renal tumors: A retrospective analysis of multi-center results",
abstract = "Study Type - Therapy (case series) Level of Evidence 4 What's known on the subject? and What does the study add? While laparoscopic radical nephrectomy (LRN) has been confirmed in various studies to be at least as efficacious as open radical nephrectomy (ORN) in terms of oncological control and more advantageous from the perspective of minimal invasiveness, very few studies have examined its feasibility and efficacy when applied to renal masses exceeding 7 cm in size, and even fewer involved results obtained from multicentre investigations. The present study retrospectively reviewed the outcome of LRN for masses exceeding 7 cm in size carried out in 26 institutions between 2000 and 2007 and concluded that LRN offers results comparable to ORN in terms of both tumour control and procedure-associated morbidities. Furthermore, details from the study suggest that while the size of renal mass that can be treated using LRN may not be a necessarily limiting factor, the experience of the laparoscopic surgeon is a primary determinant in the overall outcome. OBJECTIVE To assess the feasibility and oncologic efficacy of laparoscopic radical nephrectomy (LRN) compared with open radical nephrectomy (ORN) in patients with large renal cell carcinomas (RCCs) >7 cm in size. PATIENTS AND METHODS We analysed the data from 255 patients who underwent radical nephrectomies at 26 institutions in Korea between January 2000 and December 2007 for RCCs > 7 cm in size. Eighty-eight patients who underwent LRNs were compared with 167 patients who underwent ORNs. The patients with tumor thrombi in the renal vein or IVC, and lymph node or distant metastases were excluded. We compared the operative time, estimated blood loss, complication rates, and 2-year overall and disease-free survival rates between the LRN and ORN groups. RESULTS The median duration of postoperative follow-up was 19 months for the LRN group and 25.8 months for the ORN group. The operative time was significantly longer in the LRN group than in the ORN group (241.5 ± 74.8 min vs 202.7 ± 69.6 min, P < 0.001) and blood loss was significantly lower in the LRN group than in the ORN group (439.8 ± 326.8 mL vs 604.4 ± 531.4 mL, P = 0.006). No statistically significant difference was found in complication rates, the 2-year overall (92.7{\%} vs 94{\%}, P = 0.586) and disease-specific (90.1{\%} vs 93.7{\%}, P = 0.314) survival rates between the LRN and ORN groups. CONCLUSIONS Despite the longer operative time, LRN was an effective and less invasive treatment option for clinical T2 renal tumors. It achieved a degree of cancer control similar to that obtained with ORN.",
author = "Jeon, {Seung Hyun} and Kwon, {Tae Gyun} and Rha, {Koon Ho} and Sung, {Gyung Tak} and Wan Lee and Lim, {Jae Sung} and Jeong, {Young Beom} and Hong, {Sung Hoo} and Kim, {Hyeon Hoe} and Byun, {Seok Soo}",
year = "2011",
month = "3",
day = "1",
doi = "10.1111/j.1464-410X.2010.09688.x",
language = "English",
volume = "107",
pages = "817--821",
journal = "BJU International",
issn = "1464-4096",
publisher = "Wiley-Blackwell",
number = "5",

}

Comparison of laparoscopic versus open radical nephrectomy for large renal tumors : A retrospective analysis of multi-center results. / Jeon, Seung Hyun; Kwon, Tae Gyun; Rha, Koon Ho; Sung, Gyung Tak; Lee, Wan; Lim, Jae Sung; Jeong, Young Beom; Hong, Sung Hoo; Kim, Hyeon Hoe; Byun, Seok Soo.

In: BJU International, Vol. 107, No. 5, 01.03.2011, p. 817-821.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Comparison of laparoscopic versus open radical nephrectomy for large renal tumors

T2 - A retrospective analysis of multi-center results

AU - Jeon, Seung Hyun

AU - Kwon, Tae Gyun

AU - Rha, Koon Ho

AU - Sung, Gyung Tak

AU - Lee, Wan

AU - Lim, Jae Sung

AU - Jeong, Young Beom

AU - Hong, Sung Hoo

AU - Kim, Hyeon Hoe

AU - Byun, Seok Soo

PY - 2011/3/1

Y1 - 2011/3/1

N2 - Study Type - Therapy (case series) Level of Evidence 4 What's known on the subject? and What does the study add? While laparoscopic radical nephrectomy (LRN) has been confirmed in various studies to be at least as efficacious as open radical nephrectomy (ORN) in terms of oncological control and more advantageous from the perspective of minimal invasiveness, very few studies have examined its feasibility and efficacy when applied to renal masses exceeding 7 cm in size, and even fewer involved results obtained from multicentre investigations. The present study retrospectively reviewed the outcome of LRN for masses exceeding 7 cm in size carried out in 26 institutions between 2000 and 2007 and concluded that LRN offers results comparable to ORN in terms of both tumour control and procedure-associated morbidities. Furthermore, details from the study suggest that while the size of renal mass that can be treated using LRN may not be a necessarily limiting factor, the experience of the laparoscopic surgeon is a primary determinant in the overall outcome. OBJECTIVE To assess the feasibility and oncologic efficacy of laparoscopic radical nephrectomy (LRN) compared with open radical nephrectomy (ORN) in patients with large renal cell carcinomas (RCCs) >7 cm in size. PATIENTS AND METHODS We analysed the data from 255 patients who underwent radical nephrectomies at 26 institutions in Korea between January 2000 and December 2007 for RCCs > 7 cm in size. Eighty-eight patients who underwent LRNs were compared with 167 patients who underwent ORNs. The patients with tumor thrombi in the renal vein or IVC, and lymph node or distant metastases were excluded. We compared the operative time, estimated blood loss, complication rates, and 2-year overall and disease-free survival rates between the LRN and ORN groups. RESULTS The median duration of postoperative follow-up was 19 months for the LRN group and 25.8 months for the ORN group. The operative time was significantly longer in the LRN group than in the ORN group (241.5 ± 74.8 min vs 202.7 ± 69.6 min, P < 0.001) and blood loss was significantly lower in the LRN group than in the ORN group (439.8 ± 326.8 mL vs 604.4 ± 531.4 mL, P = 0.006). No statistically significant difference was found in complication rates, the 2-year overall (92.7% vs 94%, P = 0.586) and disease-specific (90.1% vs 93.7%, P = 0.314) survival rates between the LRN and ORN groups. CONCLUSIONS Despite the longer operative time, LRN was an effective and less invasive treatment option for clinical T2 renal tumors. It achieved a degree of cancer control similar to that obtained with ORN.

AB - Study Type - Therapy (case series) Level of Evidence 4 What's known on the subject? and What does the study add? While laparoscopic radical nephrectomy (LRN) has been confirmed in various studies to be at least as efficacious as open radical nephrectomy (ORN) in terms of oncological control and more advantageous from the perspective of minimal invasiveness, very few studies have examined its feasibility and efficacy when applied to renal masses exceeding 7 cm in size, and even fewer involved results obtained from multicentre investigations. The present study retrospectively reviewed the outcome of LRN for masses exceeding 7 cm in size carried out in 26 institutions between 2000 and 2007 and concluded that LRN offers results comparable to ORN in terms of both tumour control and procedure-associated morbidities. Furthermore, details from the study suggest that while the size of renal mass that can be treated using LRN may not be a necessarily limiting factor, the experience of the laparoscopic surgeon is a primary determinant in the overall outcome. OBJECTIVE To assess the feasibility and oncologic efficacy of laparoscopic radical nephrectomy (LRN) compared with open radical nephrectomy (ORN) in patients with large renal cell carcinomas (RCCs) >7 cm in size. PATIENTS AND METHODS We analysed the data from 255 patients who underwent radical nephrectomies at 26 institutions in Korea between January 2000 and December 2007 for RCCs > 7 cm in size. Eighty-eight patients who underwent LRNs were compared with 167 patients who underwent ORNs. The patients with tumor thrombi in the renal vein or IVC, and lymph node or distant metastases were excluded. We compared the operative time, estimated blood loss, complication rates, and 2-year overall and disease-free survival rates between the LRN and ORN groups. RESULTS The median duration of postoperative follow-up was 19 months for the LRN group and 25.8 months for the ORN group. The operative time was significantly longer in the LRN group than in the ORN group (241.5 ± 74.8 min vs 202.7 ± 69.6 min, P < 0.001) and blood loss was significantly lower in the LRN group than in the ORN group (439.8 ± 326.8 mL vs 604.4 ± 531.4 mL, P = 0.006). No statistically significant difference was found in complication rates, the 2-year overall (92.7% vs 94%, P = 0.586) and disease-specific (90.1% vs 93.7%, P = 0.314) survival rates between the LRN and ORN groups. CONCLUSIONS Despite the longer operative time, LRN was an effective and less invasive treatment option for clinical T2 renal tumors. It achieved a degree of cancer control similar to that obtained with ORN.

UR - http://www.scopus.com/inward/record.url?scp=79952265367&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=79952265367&partnerID=8YFLogxK

U2 - 10.1111/j.1464-410X.2010.09688.x

DO - 10.1111/j.1464-410X.2010.09688.x

M3 - Article

C2 - 21029315

AN - SCOPUS:79952265367

VL - 107

SP - 817

EP - 821

JO - BJU International

JF - BJU International

SN - 1464-4096

IS - 5

ER -