Comparison of Laparoscopic and Open Partial Nephrectomies in T1a Renal Cell Carcinoma: A Korean Multicenter Experience.
10.4111/kju.2010.51.7.467
- Author:
Hongzoo PARK
1
;
Seok Soo BYUN
;
Hyeon Hoe KIM
;
Seung Bae LEE
;
Tae Gyun KWON
;
Seung Hyun JEON
;
Seok Ho KANG
;
Seong Il SEO
;
Tae Hee OH
;
Youn Soo JEON
;
Wan LEE
;
Tae Kon HWANG
;
Koon Ho RHA
;
Ill Young SEO
;
Dong Deuk KWON
;
Yong June KIM
;
Yunhee CHOI
;
Sue Kyung PARK
Author Information
1. Department of Urology, School of Medicine, Kangwon National University, Chuncheon, Korea.
- Publication Type:Multicenter Study ; Original Article
- Keywords:
Glomerular filtration rate;
Kidney neoplasms;
Nephrectomy;
Outcomes assessment
- MeSH:
Carcinoma, Renal Cell*;
Cohort Studies;
Demography;
Follow-Up Studies;
Glomerular Filtration Rate;
Hemorrhage;
Humans;
Ischemia;
Kidney Neoplasms;
Korea;
Nephrectomy*;
Outcome Assessment (Health Care)
- From:Korean Journal of Urology
2010;51(7):467-471
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: We analyzed a series of patients who had undergone laparoscopic partial nephrectomies (LPNs) and open partial nephrectomies (OPNs) to compare outcomes of the two procedures in patients with pathologic T1a renal cell carcinomas (RCCs). MATERIALS AND METHODS: From January 1998 to May 2009, 417 LPNs and 345 OPNs were performed on patients with small renal tumors in 15 institutions in Korea. Of the patients, 273 and 279 patients, respectively, were confirmed to have pT1a RCC. The cohorts were compared with respect to demographics, peri-operative data, and oncologic and functional outcomes. RESULTS: The demographic data were similar between the groups. Although the tumor location was more exophytic (51% vs. 44%, p=0.047) and smaller (2.1 cm vs. 2.3 cm, p=0.026) in the LPN cohort, the OPN cohort demonstrated shorter ischemia times (23.4 min vs. 33.3 min, p<0.001). The LPN cohort was associated with less blood loss than the OPN cohort (293 ml vs. 418 ml, p<0.001). Of note, two patients who underwent LPNs had open conversions and nephrectomies were performed because of intra-operative hemorrhage. The decline in the glomerular filtration rate at the last available follow-up (LPN, 10.9%; and OPN, 10.6%) was similar in both groups (p=0.8). Kaplan-Meier estimates of 5-year local recurrence-free survival (RFS) were 96% after LPN and 94% after OPN (p=0.8). CONCLUSIONS: The LPN group demonstrated similar rates of recurrence-free survival, complications, and postoperative GFR change compared with OPN group. The LPN may be an acceptable surgical option in patients with small RCC in Korea.
