Researchers from the University of Southern California have reported that “Long-term oncological outcomes after laparoscopic radical nephrectomy (LRN) for renal cell carcinoma are excellent and comparable to those of open surgery.” The details of this study appeared in the Journal of Urology early online on September 14, 2009.[1]

Laparoscopic radical nephrectomy has been performed for the treatment of renal cell carcinoma since 1991. Many studies have shown that LRN is associated with shorter hospital stays, less pain, and an earlier return to normal activities compared with open radical nephrectomy. Most studies have shown recurrence rates and cancer-specific survival rates to be comparable to open surgery. More recently, LRN has been utilized for the removal of kidneys from normal donors for transplantation. Laparoscopic radical nephrectomy is now considered to be the technique of choice for treating T1 and T2 and probably T3 renal cell carcinoma as well. However, there are few reports with 10 or more years of follow-up.

The current study evaluated outcomes of LRN in 93 patients with renal cell carcinoma with a minimum of 10 years follow-up (10-15 years). Patients in this study were treated by two surgeons. Seventy-one percent of patients had T1, 15% had T2, 10% had T3, and 3% had T4 tumors.

• 10-year overall survival was 65%.
• 10-.year cancer specific survival was 92%.
• 10-year recurrence-free survival was 86%.
• 10 patients developed metastatic disease with eight deaths.

Comments: These data are similar to other reports confirming that LRN is the treatment of choice for most patients with renal cell carcinoma. There are currently studies being carried out with robotic techniques to possibly further improve surgical treatment of renal cell carcinoma.

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