Laparoscopic vs open partial nephrectomy for T1 renal tumors: evaluation of the long-term oncologic and functional outcomes in 340 patients

==inizio abstract==

Objective: To evaluate the long-term oncological and functional outcomes of laparoscopic partial nephrectomy (LPN) compared with open PN (OPN) for pT1 renal tumors.
Methods and Results: In this retrospective single-centre study, 340 consecutive patients underwent LPN and OPN for localised incidentally discovered renal masses of < 7 cm (cT1). The patients were matched for age, sex, body mass index, ASA score, tumor side (right or left kidney) and tumor characteristics (R.E.N.A.L. nephrometry score). Demographic data, peri- and postoperative variables, including operative duration, estimated blood loss, complications, hospital stay, renal function, histological tumor staging and grading, and metastasis rates were collected and analysed. The median operative duration for LPN and OPN was 145.3 ± 45.4 min and 155.2 ± 35.6 min, respectively (P = 0.07). The median warm ischemia time (WIT) was 11.7 ± 2.2 min in the LPN and 14.4±1.9 min in the OPN group (P = 0.03). The median R.E.N.A.L nephrometry score for LPN and OPN was 5.9±1.6 and 6.1±0.3 (p=0.11), respectively. During follow-up, the biochemical markers of glomerular filtration were completely normalized, showing the absence of renal injury and there was no statistically significant difference in glomerular filtration rate between the groups, with a median of 79.8 ± 3.0 mL/min/1.72m2 for the LPN and 80.2± 2.7 mL/min/1.72m2 for the OPN group at the 5-year follow-up. The 5-year overall survival and cancer-specific survival, calculated using the Kaplan–Meier method, were 94% and 91% in the LPN group, and 92% and 88% in the OPN group. Conclusion: Laparoscopic and open partial nephrectomy provides similar long-term oncologic outcomes in the therapy of T1 renal cancer. Concerning the renal function, no damage to the kidney could be evidenced after LPN and OPN, with a complete normalization of renal function at the 5-year follow-up in both groups. ==fine abstract==