Laparoscopic Cytoreductive Nephrectomy With Cytokine Therapy For Metastatic Renal Cell Carcinomas Compared With Open Nephrectomy

Introduction: We retrospectively reviewed and compared the operation records and long-term results of patients with metastatic renal cell carcinoma (mRCC) who underwent laparoscopic cytoreductive nephrectomy and those who underwent open procedure.Methods: A total of 75 patients with mRCC who underwent cytoreductive nephrectomy between 1997 and 2007 were studied: 23 patients in the laparoscopy group (LCN group) and 52 in the open group (OCN group). Most patients received interferon-based cytokine therapy after surgery. Patients with tumor thrombus in the inferior vena cava were excluded from this study.Results: Operating time in the LCN group was significantly longer than in the OCN group (320.3 min vs 269.6 min, P = 0.049). Blood loss was less in the LCN group (527.8 ml) than in the OCN group (1372.3 ml, P = 0.072). Convalescence was shorter in the LCN group (18.1 d) than in the OCN group (32.9 d, Po0.0001). Median follow-up periods were 15 months (range 2-110 months) and 17 months (range 1-103 months) in the LCN group and OCN group, respectively. There was no statistically significant difference between the two groups with regard to disease-specific patient survival and progression-free survival.Conclusions: Laparoscopic cytoreductive nephrectomy is a feasible alternative for patients with mRCC because its benefits include less blood loss and shorter convalescence. In addition, the long-term oncological results of laparoscopic cytoreductive nephrectomy are comparable to those of the open procedure.