Minimally invasive cytoreductive nephrectomy: a multi-institutional experience.
Luciano Nunez Bragayrac1, Jan Hoffmeyer2, Daniel Abbotoy3
1Department of Urology, Roswell Park Cancer Institute, Elm & Carlton Streets, Buffalo, NY, 14263, USA. Luciano.NunezBragayrac@RoswellPark.org.
World Journal of Urology
|April 17, 2016
Summary
Minimally invasive cytoreductive nephrectomy (CN) is a safe and feasible procedure for metastatic renal cell carcinoma. This approach offers acceptable morbidity and oncologic outcomes in experienced surgical centers.
Area of Science:
- Urology
- Surgical Oncology
- Nephrology
Background:
- Cytoreductive nephrectomy (CN) is a treatment for metastatic renal cell carcinoma.
- Minimally invasive surgical techniques are increasingly adopted for complex oncologic procedures.
Purpose of the Study:
- To evaluate the functional and oncologic outcomes of minimally invasive cytoreductive nephrectomy (CN).
- To assess the safety and feasibility of minimally invasive CN across three high-volume cancer centers.
Main Methods:
- A retrospective analysis of prospectively maintained databases from three high-volume cancer centers.
- Inclusion of patients who underwent minimally invasive (laparoscopic, hand-assisted, or robotic) CN for metastatic renal cell carcinoma between 2001 and 2013.
Main Results:
- 120 patients underwent minimally invasive CN, predominantly radical (93.3%) and laparoscopic (96.6%).
- Median operative time was 210 minutes with low estimated blood loss (150 cc) and transfusion rates (9.2%).
- Overall survival was 25.7 months, with a 3-year survival rate of 35%; hypertension, brain metastasis, and pT stage were associated with worse survival.
Conclusions:
- Minimally invasive cytoreductive nephrectomy is a safe and feasible surgical option for select patients with metastatic renal cell carcinoma.
- Experienced surgical teams can achieve acceptable morbidity and oncologic outcomes using minimally invasive approaches for CN.
