Long-Term Oncologic Outcomes of Hand-Assisted Laparoscopic Radical Nephrectomy for Clinically Localized Renal Cell Carcinoma: A Multi-institutional Comparative Study
- Authors
- Park, Yong Hyun; Lee, Eun Sik; Kim, Hyeon Hoe; Kwak, Cheol; Ku, Ja Hyeon; Lee, Sang Eun; Byun, Seok-Soo; Hong, Sung Kyu; Kim, Yong-June; Kang, Seok Ho; Hong, Sung Hoo
- Issue Date
- 8월-2014
- Publisher
- MARY ANN LIEBERT, INC
- Citation
- JOURNAL OF LAPAROENDOSCOPIC & ADVANCED SURGICAL TECHNIQUES, v.24, no.8, pp.556 - 562
- Indexed
- SCIE
SCOPUS
- Journal Title
- JOURNAL OF LAPAROENDOSCOPIC & ADVANCED SURGICAL TECHNIQUES
- Volume
- 24
- Number
- 8
- Start Page
- 556
- End Page
- 562
- URI
- https://scholar.korea.ac.kr/handle/2021.sw.korea/97743
- DOI
- 10.1089/lap.2014.0035
- ISSN
- 1092-6429
- Abstract
- Background: We aimed to assess the long-term oncologic outcome of hand-assisted laparoscopic radical nephrectomy (HLRN) compared with open radical nephrectomy (ORN) in patients with clinically localized renal cell carcinoma (RCC). Patients and Methods: We retrospectively reviewed the data from 1098 patients who underwent radical nephrectomy at five institutions in Korea between 2000 and 2011 for clinically localized RCC. One hundred ninety-seven patients in the HLRN group were compared with 901 patients in the ORN group. Univariate and multivariate analysis assessed the effects of operative method on oncologic outcomes. Results: The median duration of follow-up was 69 months for the HLRN group and 63 months for the ORN group. No statistically significant difference was found in the operative time (170.2 minutes versus 168.9 minutes, P=.793) between the HLRN and ORN groups. However, estimated blood loss was significantly lower in the HLRN group than in the ORN group (245.9mL versus 422.4mL, P<.001). The pathological T stage was significantly higher in patients in the ORN group: 79.9% of patients in the HLRN group derived from pT1, versus 54.7% of those in the ORN group (P<.001). A statistically significant difference was found in the 5-year disease-free (90.6% versus 79.6%, P<.001), cancer-specific (95.7% versus 91.1%, P=.019), and overall (93.4% versus 85.4%, P<.001) survival between the HLRN and ORN groups. However, multivariate analysis by Cox's proportional hazards model does not retain surgical methods as an independent predictive factor for cancer-related death or recurrence. Conclusions: HLRN may be a preferable minimally invasive surgical treatment for clinically localized RCC with comparable long-term oncologic outcomes.
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