Oncological Outcome of Contemporary Radical Nephrectomy for pT1 Renal Cell Carcinoma: Comparison of Open versus Laparoscopic Approach

Background: This study retrospectively compared cancer control in patients with pT1 renal cell carcinoma (RCC) undergoing either open radical nephrectomy (ORN) or laparoscopic radical nephrectomy (LRN). Patients and Methods: This study included 710 consecutive patients who underwent radical nephrectomy for clinically localized RCC at 21 institutions in Japan between January 2000 and March 2008, and were diagnosed as having pT1 disease. The medical records of all patients were reviewed with emphasis on their oncological outcomes. Results: Of the 710 patients, 436 (61.4%) and 274 (38.6%) were treated with ORN and LRN, respectively. Although patient age in the ORN group was significantly older than that in the LRN group, there were no significant differences in the remaining characteristics, including gender distribution, mode of presentation, pathological stage, grade, micro-venous invasion and histological subtype, between the two groups. None of the patients in the LRN group developed port site metastasis, while renal fossa recurrence occurred in 2 patients in both the ORN and LRN groups. Furthermore, there were no significant differences in the recurrence-free, cancer-specific and overall survival rates between these two groups. Conclusions: LRN had no adverse impact on intermediateterm oncological outcomes compared with that after ORN in patients with pT1 RCC; however, additional prospective trials would be needed to draw definitive conclusions on this issue.