BACKGROUND AND PURPOSE: Local recurrence is rare after radical nephrectomy for clinically localized renal-cell carcinoma (RCC). Aggressive open surgical resection of isolated local recurrence has been shown to offer durable local control and potential improvement in cancer-specific survival. The objective of this study is to assess early outcomes on a select group of patients who underwent laparoscopic resection of isolated local recurrence after radical nephrectomy for clinically localized RCC. PATIENTS AND METHODS: The perioperative and clinical outcomes of four patients who underwent laparoscopic resection of local recurrence between 2007 and 2009 by a single surgeon were reviewed. RESULTS: Two patients underwent resection of ipsilateral adrenal recurrence while the remaining two underwent resection of recurrence in retroperitoneal lymph nodes. The mean age of patients was 57 years (44-66 y), all had primary tumors with clear-cell histology, and Eastern Cooperative Oncology Group performance status was 0. The mean recurrence size was 5 cm (3-7 cm). All surgical margins were negative. Mean operative time was 195 minutes (170-210 min), and mean estimated blood loss was 187 mL (100-250 mL). No patient needed blood transfusion. Mean length of stay was 2.5 days (2-3 d). At a mean follow-up of 12 months (2-26 mos), 1 patient experienced further recurrence. All patients are alive, and three have no evidence of disease. CONCLUSIONS: Aggressive surgical resection of isolated local recurrence of RCC after radical nephrectomy with curative intent may be beneficial and has traditionally been performed using open surgery. In our limited experience, a laparoscopic approach may be used in selected patients with small well-circumscribed recurrences with low morbidity and excellent short-term outcomes.
BACKGROUND AND PURPOSE: Local recurrence is rare after radical nephrectomy for clinically localized renal-cell carcinoma (RCC). Aggressive open surgical resection of isolated local recurrence has been shown to offer durable local control and potential improvement in cancer-specific survival. The objective of this study is to assess early outcomes on a select group of patients who underwent laparoscopic resection of isolated local recurrence after radical nephrectomy for clinically localized RCC. PATIENTS AND METHODS: The perioperative and clinical outcomes of four patients who underwent laparoscopic resection of local recurrence between 2007 and 2009 by a single surgeon were reviewed. RESULTS: Two patients underwent resection of ipsilateral adrenal recurrence while the remaining two underwent resection of recurrence in retroperitoneal lymph nodes. The mean age of patients was 57 years (44-66 y), all had primary tumors with clear-cell histology, and Eastern Cooperative Oncology Group performance status was 0. The mean recurrence size was 5 cm (3-7 cm). All surgical margins were negative. Mean operative time was 195 minutes (170-210 min), and mean estimated blood loss was 187 mL (100-250 mL). No patient needed blood transfusion. Mean length of stay was 2.5 days (2-3 d). At a mean follow-up of 12 months (2-26 mos), 1 patient experienced further recurrence. All patients are alive, and three have no evidence of disease. CONCLUSIONS: Aggressive surgical resection of isolated local recurrence of RCC after radical nephrectomy with curative intent may be beneficial and has traditionally been performed using open surgery. In our limited experience, a laparoscopic approach may be used in selected patients with small well-circumscribed recurrences with low morbidity and excellent short-term outcomes.
Authors: Q Tang; R C Lin; L Yao; Z Zhang; H Hao; C J Zhang; L Cai; X S Li; Z S He; L Q Zhou Journal: Beijing Da Xue Xue Bao Yi Xue Ban Date: 2019-08-18
Authors: Arun Z Thomas; Mehrad Adibi; Leonardo D Borregales; Ly N Hoang; Pheroze Tamboli; Eric Jonasch; Nizar M Tannir; Surena F Matin; Christopher G Wood; Jose A Karam Journal: J Urol Date: 2015-03-07 Impact factor: 7.450