Laparoscopic versus open cytoreductive nephrectomy for metastatic renal cell carcinoma

Rabets, John; Kaouk, Jihad; Fergany, Amr; Finelli, Antonio; Gill, Inderbir S.; Novick, Andrew C.

doi:10.1016/j.urology.2004.06.052

Cited by 79 publications

(52 citation statements)

References 8 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Inicialmente se apuntó que las ventajas inherentes a la cirugía laparoscópica se traducían en un inicio de la inmunoterapia un mes antes que con la vía abierta, además de hipotetizar una respuesta más favorable del sistema inmune ante la menor agresión quirúrgica, pero el mismo grupo no objetivó posteriormente diferencias en supervivencia cáncer específica 44 . Existen trabajos recientes en los que se confirman ese dato 45,46 y en los que no se demuestran diferencias en la respuesta inmune según la nefrectomía se haga abierta o laparoscópica 47 .…”

Section: Resultados Oncológicosunclassified

Nefrectomía radical laparoscópica

et al. 2006

View full text Add to dashboard Cite

RESUMENNEFRECTOMÍA RADICAL LAPAROSCÓPICA Revisamos en este artículo los distintas abordajes quirúrgicos para realizar una nefrectomía radical laparoscópica, la vía transperitoneal, la retroperitoneal, así como la mano-asistida.Describimos las ventajas e inconvenientes de cada una de estas alternativas así como resumimos los citas bibliográficas más importantes en la literatura médica con respecto a las mismas.A pesar de que es una cirugía con una corta existencia, menos de 15 años, ha conseguido convertirse en un estándar de tratamiento y hoy puede considerarse en muchos centros como la cirugía de elección en tumores de riñón T1 y T2.Palabras clave: Laparoscopia. Nefrectomía radical. ABSTRACT RADICAL LAPAROSCOPIC NEPHRECTOMYIn this article, we review the different surgical approaches to carry out radical laparoscopic nephrectomy: transperitoneal approach, retroperitoneal approach and hand-assisted approach. We describe the advantages and drawbacks of each alternative and summarize the most important references in the medical literature. In spite of this being a relatively new surgical approach, less than 15 years old, it has become a standard treatment and, today, is considered as the elective surgical treatment for T1 and T2 renal tumours in many centres.

show abstract

Section: Resultados Oncológicosunclassified

Nefrectomía radical laparoscópica

et al. 2006

View full text Add to dashboard Cite

show abstract

“…Several series have reported that in wellselected cases, laparoscopic CN is feasible and safe. Rabets and colleagues, 41 in their series of 22 patients who underwent laparoscopic CN reported that their results compared favourably with those for open surgery; they had a shorter operative time (40 min), less blood loss (by 940 mL) and a shorter hospital stay (by 3.8 d). However, tumours were larger in the open group (9.5 cm v. 7.9 cm; p < 0.04).…”

Section: 40mentioning

confidence: 97%

New surgical horizons: the role of cytoreductive nephrectomy for metastatic kidney cancer

Rendon

2012

CUAJ

View full text Add to dashboard Cite

The rationale for CN was initially founded on early reports of spontaneous regression of metastases after nephrectomy alone in up to 7% of cases. 7 The actual incidence of spontaneous regression of RCC is unknown, since the denominator is rarely specified in these reports. In 1982, Snow and Schellhammer 8 indicated that the incidence is less than 1% and that regression is a "fortuitous event rather than the rule." The mechanism for spontaneous regression is unclear, although immunologic factors have been implicated. Because most spontaneous regressions have been observed in the lungs, Freed and colleagues 9 postulated that this organ has a large number of macrophages and lymphocytes, and a large amount of immunoglobulin that are suppressed until the primary tumour is removed. Another immunologic theory that supports CN implies that there might be a host immune dysfunction, and poor recognition and presentation of antigens. 10 It also has been postulated that cytokines and growth factors are released by the primary tumour and promote the growth of metastases that could be avoided through surgical removal of the renal mass. Other advantages of CN are the lack of response of the primary lesion to cytokine therapy, regardless of the grade of response at metastatic sites. The removal of the source of potential new metastases and the overall debulking of the tumoral mass has also been hypothesized as a possible benefit of CN. 11 Improvement of quality of lifeThe role of palliative nephrectomy is controversial. Traditional indications for it have been hematuria, pain and paraneoplastic syndromes (e.g., hypercalcemia, hypertension, fever, aneNew surgical horizons: the role of cytoreductive nephrectomy for metastatic kidney cancer REVIEW AbstractRenal cell carcinoma is the most lethal urologic malignancy. Up to 30% of patients with kidney cancer have metastatic disease and 30% of those treated for local or locally advanced disease will progress to metastases. Radical nephrectomy is the standard treatment for the management of nondisseminated kidney cancer, but the role of cytoreductive nephrectomy for patients with metastatic disease is controversial. In this paper, the rationale for cytoreductive nephrectomy is described and the currently available evidence for and against it is evaluated. The different approaches to defining prognostic factors to select which patients will benefit from cytoreductive nephrectomy will also be described. Finally, the role of cytoreductive nephrectomy in the era of new targeted therapies is discussed.

show abstract

“…This is distinct from the established use of minimal access approaches for radical nephrectomy in primary CC-RCC, where the natural history of the disease is different. However, data from Rabets et al [24] suggest that patients treated with laparoscopic nephrectomy have an equivalent 1-year survival rate to those treated with open nephrectomy (61% versus 65%), but notably, a shorter time to initiation of immunotherapy (36 versus 61 days; p Ͻ .01). The laparoscopic approach was also associated with significantly less blood loss (288 ml versus 1,228 ml; p Ͻ .001), but there were no differences in the duration of surgery or the nonhemostatic complication rates.…”

Section: Operative Morbidity From Cytoreductive Nephrectomy In Mcc-rcmentioning

confidence: 99%

Cytoreductive Nephrectomy in Metastatic Clear-Cell Renal Cell Carcinoma: Perspectives in the Tyrosine Kinase Inhibitor Era

2009

View full text Add to dashboard Cite

Section editors Chris Parker and Matthew R. Smith have disclosed no financial relationships relevant to the content of this article.The content of this article has been reviewed by independent peer reviewers to ensure that it is balanced, objective, and free from commercial bias. Target audience:Physicians who wish to advance their current knowledge of clinical cancer medicine in genitourinary cancer. LEARNING OBJECTIVES1. Summarize the relationship of data on nephrectomy in metastatic RCC to immunotherapy.2. Apply to your practice available prognostic predictive scoring systems.3. Compare and contrast the potential benefits and costs of cytoreductive nephrectomy in the TKI era.This article is available for continuing medical education credit at CME.TheOncologist.com. This review summarizes the evidence for the management of mCC-RCC and outlines novel approaches to be tested within future trials if the initial proposed phase III trials in this setting, using sunitinib, are successful. Overall, two prin- CME CME ABSTRACT

show abstract

Laparoscopic versus open cytoreductive nephrectomy for metastatic renal cell carcinoma

Cited by 79 publications

References 8 publications

Nefrectomía radical laparoscópica

Nefrectomía radical laparoscópica

New surgical horizons: the role of cytoreductive nephrectomy for metastatic kidney cancer

Cytoreductive Nephrectomy in Metastatic Clear-Cell Renal Cell Carcinoma: Perspectives in the Tyrosine Kinase Inhibitor Era

Contact Info

Product

Resources

About