Oncological outcomes of hand-assisted laparoscopic radical nephrectomy for clinically localized renal cell carcinoma:: a single-institution study with ≥3 years of follow-up

To evaluate the intermediate-term outcomes of hand-assisted laparoscopic radical nephrectomy (HALRN) for clinically organ-confined renal cell carcinoma (RCC). We retrospectively reviewed patients who had HALRN for clinically organ-confined RCC at the University of Wisconsin from 1996 to 2003. All patients with pathologically confirmed RCC and with >= 3 years of follow-up were included in a retrospective chart review of variables before, during and after HALRN, as well as the clinical outcomes. In all, 75 patients had HALRN in the study period; their mean age was 59 years, body mass index 29 kg/m(2), operative duration 227 min, estimated blood loss 130 mL, and none required conversion to open nephrectomy. The median time to first oral intake was 2.5 days and the median hospital stay 4 days. On pathological examination the mean tumour size was 5.8 cm; 70% were pT1, 26% pT2 and 4% pT3; 82% were clear cell, 9% papillary, 8% chromophobe and 1% collecting duct carcinoma. Of the 65 patients who had a follow-up of >= 36 months (mean 46, range 36-117), the 3- and 5-year disease-free survival rate was 93.4% and 90.2%, respectively; the 3- and 5-year cancer-specific survival rate was 96.5% and 94.4%, respectively. Our study suggests that HALRN is a safe and minimally invasive treatment for managing clinically organ-confined RCC, with good intermediate-term oncological outcomes.