Jasmir G Nayak1, Premal Patel2, Jennifer Bjazevic2, Zhihui Liu3, Olli Saarela4, Anil Kapoor5, Ricardo Rendon6, Jun Kawakami7, Simon Tanguay8, Rodney H Breau9, Peter C Black10, Darrel E Drachenberg11. 1. Section of Urology, University of Manitoba, Winnipeg, MB;; Department of Urology, University of Washington, Seattle, WA; 2. Department of Urology, University of Washington, Seattle, WA; 3. Cancer Care Ontario, Toronto, ON; 4. Dalla Lana School of Public Health, University of Toronto, Toronto, ON; 5. Division of Urology, McMaster University, Hamilton, ON; 6. Department of Urology, Dalhousie University, Halifax, NS; 7. Southern Alberta Institute of Urology, University of Calgary, Calgary, AB; 8. Division of Urology, McGill University, Montreal, QC; 9. The Ottawa Hospital Research Institute, University of Ottawa, Ottawa, ON; 10. Department of Urologic Sciences, University of British Columbia, Vancouver, BC. 11. Section of Urology, University of Manitoba, Winnipeg, MB;
Abstract
INTRODUCTION: We described the clinical and oncological outcomes of patients treated by laparoscopic surgery for non-metastatic pT3 renal cell carcinoma (RCC). METHODS: We queried a multi-institutional database for patients diagnosed with non-metastatic pathological T3 RCC from 13 Canadian centres treated laparoscopically (radical or partial nephrectomy) between 2008 and 2014. Clinical and pathological outcomes were evaluated. Progression was defined as the development of recurrence or metastatic disease. Log-rank testing and Kaplan-Meier statistical methods assessed for differences and estimated progression-free survival (PFS). RESULTS: In total, 176 patients were identified with a median age of 64 years. The median tumour size was 7.0 cm. Pre-clinical stage was cT1 to cT4 in 39%, 28%, 30% and 3%, respectively. The median blood loss was 150 mL (range: 0-6000) and the median operative time was 124 minutes (range: 60-360). Most lesions were clear cell RCC (80%). After a median follow-up of 17.6 months (range: 0.2-75.0), disease progression occurred in 26% (46/176) of patients, consisting of local recurrence in 7% (3/46), and metastatic disease in 93% (43/46). The 3-year PFS was 67%, with a median PFS of 49 months. Of those who progressed, the median time to progression was 10.3 months. CONCLUSIONS: This study is the largest cohort of pT3 RCC patients treated laparoscopically in the literature and suggests that for properly selected patients, laparoscopic management of locally advanced renal masses yields acceptable short-term oncological outcomes.
INTRODUCTION: We described the clinical and oncological outcomes of patients treated by laparoscopic surgery for non-metastatic pT3renal cell carcinoma (RCC). METHODS: We queried a multi-institutional database for patients diagnosed with non-metastatic pathological T3 RCC from 13 Canadian centres treated laparoscopically (radical or partial nephrectomy) between 2008 and 2014. Clinical and pathological outcomes were evaluated. Progression was defined as the development of recurrence or metastatic disease. Log-rank testing and Kaplan-Meier statistical methods assessed for differences and estimated progression-free survival (PFS). RESULTS: In total, 176 patients were identified with a median age of 64 years. The median tumour size was 7.0 cm. Pre-clinical stage was cT1 to cT4 in 39%, 28%, 30% and 3%, respectively. The median blood loss was 150 mL (range: 0-6000) and the median operative time was 124 minutes (range: 60-360). Most lesions were clear cell RCC (80%). After a median follow-up of 17.6 months (range: 0.2-75.0), disease progression occurred in 26% (46/176) of patients, consisting of local recurrence in 7% (3/46), and metastatic disease in 93% (43/46). The 3-year PFS was 67%, with a median PFS of 49 months. Of those who progressed, the median time to progression was 10.3 months. CONCLUSIONS: This study is the largest cohort of pT3RCCpatients treated laparoscopically in the literature and suggests that for properly selected patients, laparoscopic management of locally advanced renal masses yields acceptable short-term oncological outcomes.
Authors: I S Gill; A M Meraney; D K Schweizer; S S Savage; M G Hobart; G T Sung; D Nelson; A C Novick Journal: Cancer Date: 2001-10-01 Impact factor: 6.860
Authors: Matthew D Shuford; Elspeth M McDougall; Sam S Chang; Bonnie J LaFleur; Joseph A Smith; Michael S Cookson Journal: Urol Oncol Date: 2004 Mar-Apr Impact factor: 3.498
Authors: A Breda; S V Stepanian; J Liao; J S Lam; G Guazzoni; M Stifelman; K Perry; A Celia; G Breda; P Fornara; S Jackman; A Rosales; J Palou; M Grasso; V Pansadoro; V Disanto; F Porpiglia; C Milani; C Abbou; R Gaston; G Janetschek; N A Soomro; J de la Rosette; M P Laguna; P G Schulam Journal: J Urol Date: 2007-05-11 Impact factor: 7.450
Authors: John S Lam; Oleg Shvarts; John T Leppert; Allan J Pantuck; Robert A Figlin; Arie S Belldegrun Journal: J Urol Date: 2005-08 Impact factor: 7.450
Authors: Christopher J Weight; Casey Lythgoe; Raman Unnikrishnan; Brian R Lane; Steven C Campbell; Amr F Fergany Journal: Urology Date: 2011-03-21 Impact factor: 2.649
Authors: Michael A Gorin; Mark W Ball; Phillip M Pierorazio; Youssef S Tanagho; Sam B Bhayani; Jihad H Kaouk; Craig G Rogers; Michael D Stifelman; Ali Khalifeh; Ramesh Kumar; Ganesh Sivarajan; Mohamad E Allaf Journal: J Urol Date: 2013-06-11 Impact factor: 7.450
Authors: A Laird; K C C Choy; H Delaney; M L Cutress; K M O'Connor; D A Tolley; S A McNeill; G D Stewart; A C P Riddick Journal: World J Urol Date: 2014-03-20 Impact factor: 4.226
Authors: Wassim Kassouf; Leonardo L Monteiro; Darrel E Drachenberg; Adrian S Fairey; Antonio Finelli; Anil Kapoor; Jean-Baptiste Lattouf; Michael J Leveridge; Nicholas E Power; Frederic Pouliot; Ricardo A Rendon; Robert Sabbagh; Alan I So; Simon Tanguay; Rodney H Breau Journal: Can Urol Assoc J Date: 2018-05-31 Impact factor: 1.862
Authors: Justin D Oake; Premal Patel; Luke T Lavallée; Jean-Baptiste Lattouf; Olli Saarela; Laurence Klotz; Ronald B Moore; Anil Kapoor; Antonio Finelli; Ricardo A Rendon; Jun Kawakami; Alan I So; Darrel E Drachenberg Journal: Can Urol Assoc J Date: 2019-07-23 Impact factor: 1.862