Comparisons of oncological outcomes and perioperative complications between laparoscopic and open radical nephrectomies in patients with clinical T2 renal cell carcinoma (≥7cm)

• Published in: PloS one Vol. 13; no. 1; p. e0191786
• Main Authors: Lee, Hakmin, Lee, Chung Un, Yoo, Jae Ho, Sung, Hyun Hwan, Jeong, Byong Chang, Jeon, Seong Soo, Lee, Hyun Moo, Choi, Han-Yong, Jeong, Chang Wook, Kwak, Cheol, Seo, Seong Il
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 24.01.2018; Public Library of Science (PLoS)
• Subjects: Biology and Life Sciences; Cancer; Carcinoma, Renal Cell - classification; Carcinoma, Renal Cell - pathology; Carcinoma, Renal Cell - surgery; Care and treatment; Comparative analysis; Complications; Complications and side effects; Cross-Sectional Studies; Data processing; Female; Health risk assessment; Histology; Hospitals; Humans; Invasiveness; Kidney cancer; Kidney Neoplasms - classification; Kidney Neoplasms - pathology; Kidney Neoplasms - surgery; Laparoscopy; Laparoscopy - adverse effects; Laparoscopy - methods; Lymphatic system; Male; Medical imaging; Medical records; Medicine; Medicine and Health Sciences; Metastasis; Middle Aged; Mortality; Multivariate Analysis; Nephrectomy; Nephrectomy - adverse effects; Nephrectomy - methods; Patient outcomes; Patients; Postoperative Complications - etiology; Proportional Hazards Models; Quality; Regression analysis; Renal cell carcinoma; Retrospective Studies; Surgery; Survival; Tumors; Urology; South Korea
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0191786

Although minimal invasive techniques have been widely accepted in contemporary urology, the perioperative outcomes of laparoscopy in patients with clinical T2 renal cell carcinoma (RCC) have not been clearly evaluated. We aimed to compare the outcomes of laparoscopic radical nephrectomy (LRN) with those of open radical nephrectomy (ORN) in patients with clinical T2 RCC. We retrospectively analyzed the data of 835 patients who underwent radical nephrectomy for localized clinical T2 RCC (≥7 cm). The survival rates and postoperative complications were compared between the LRN and ORN groups. Multivariate Cox regression tests were performed to identify the independent predictors of each survival outcome. There were 578 (69.2%) subjects in ORN group and 257 (30.8%) in LRN group, respectively. The LRN group showed a significant male predominance (p = 0.013), higher pathological stage (p = 0.02), and higher cellular grade (p = 0.010) compared with the ORN group. No significant differences in progression-free (p = 0.070), cancer-specific (p = 0.472), or overall survival (p = 0.249) were found between the two groups. In the multivariate analysis, the type of surgery did not show any significant associations with all three survival outcomes (all p > 0.2). Furthermore, there was no significant difference in postoperative complication rate between the two groups (p = 0.595). In the subgroup analysis according to tumor histology, no significant relationships were observed between survival outcome and surgery type. The LRN and ORN groups showed similar oncological outcomes in patients with clinical T2 RCC. Early postoperative complications were also comparable between LRN and ORN.