Renal cell recurrence for T1 tumors after laparoscopic partial nephrectomy
Jessica E Kreshover1, Lee Richstone, Louis R Kavoussi
1Arthur Smith Institute for Urology, North Shore-Long Island Jewish Medical Center , New Hyde Park, New York.
Journal of Endourology
|October 1, 2013
Summary
Recurrence after laparoscopic partial nephrectomy (LPN) for stage I renal cell carcinoma (RCC) is low, around 2%. Most recurrences were local and occurred within two years, with no events in non-clear cell tumors or low-grade pathologies.
Area of Science:
- Urology
- Oncology
- Nephrology
Background:
- Surveillance strategies after laparoscopic partial nephrectomy (LPN) for renal cell carcinoma (RCC) lack consensus, especially for stage I tumors.
- Characterizing recurrence rates in low-risk cohorts is crucial for refining follow-up protocols.
Purpose of the Study:
- To determine the recurrence rate of stage I renal cell carcinoma (RCC) following laparoscopic partial nephrectomy (LPN).
- To identify factors associated with recurrence in a low-risk patient cohort.
Main Methods:
- A retrospective review of patients who underwent LPN between January 2006 and May 2011 was conducted.
- Patients with stage I (pT1a/pT1b) RCC and at least one year of follow-up were analyzed.
- Recurrence rates were stratified by tumor stage and pathology.
Main Results:
- Of 360 patients with stage T1 RCC, 8 recurrences (2.2%) were observed.
- All recurrences were clear cell histology; none were Furhman grade 1.
- Most recurrences occurred locally within 1-2 years postoperatively; only one had positive margins.
Conclusions:
- Laparoscopic partial nephrectomy for stage I RCC has a low recurrence rate (approximately 2%) in low-risk patients.
- Non-clear cell pathologies, Furhman grade 1, and tumors <3cm were associated with no recurrences.
- Findings support tailored surveillance strategies for this patient group.
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