Laparoscopic cytoreductive nephrectomy for metastatic renal cell carcinoma

The theme of laparoscopy, which has been strongly stated in the mini‐review section, continues here with a paper from the Cleveland Clinic on a series of patients who had a laparoscopic nephrectomy as part of a cytoreductive strategy before immunotherapy for metatastic renal cancer. They found it sa...

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Bibliographic Details
Published in:BJU international 2004-08, Vol.94 (3), p.291-294
Main Authors: Finelli, Antonio, Kaouk, Jihad H., Fergany, Amr F., Abreu, Sidney C., Novick, Andrew C., Gill, Inderbir S.
Format: Article
Language:English
Subjects:
Biological and medical sciences
Carcinoma, Renal Cell - secondary
Carcinoma, Renal Cell - surgery
Female
Humans
Immunotherapy - methods
Kidney Neoplasms - surgery
Kidneys
laparoscopy
Laparoscopy - methods
Length of Stay
Male
Medical sciences
metastases
Middle Aged
nephrectomy
Nephrectomy - methods
Nephrology. Urinary tract diseases
renal cell carcinoma
Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases
Surgery of the urinary system
Tumors of the urinary system
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Summary:The theme of laparoscopy, which has been strongly stated in the mini‐review section, continues here with a paper from the Cleveland Clinic on a series of patients who had a laparoscopic nephrectomy as part of a cytoreductive strategy before immunotherapy for metatastic renal cancer. They found it safe and helpful in patients with tumours of 7 cm, clinical stage T2) undergoing laparoscopic radical nephrectomy (group 2) were compared retrospectively. The baseline demographics were comparable between the groups. RESULTS The mean tumour size was 8 cm in group 1 and 9.6 cm in group 2 (P = 0.07). Variables during and after surgery were comparable between the groups, with a mean operative duration of 3.1 vs 3.2 h (P = 0.82), blood loss of 285 vs 308 mL (P = 0.79), complications in two vs eight (P = 0.08), morphine sulphate equivalent requirements of 51.7 vs 44.1 mg (P = 0.1) and a median length of hospital stay of 1.7 vs 1.6 days (P = 0.68). In group 1 the median (range) time to immunotherapy was 35 (13–136) days. CONCLUSIONS Laparoscopic cytoreductive nephrectomy is safe and effective in selected patients. Currently the procedure is offered to candidates eligible for immunotherapy and with tumour
ISSN:1464-4096
1464-410X
DOI:10.1111/j.1464-410X.2004.04925.x