AUA 2018: Radical Nephrectomy for Recurrent Renal Cell Carcinoma: Patient Selection for Laparoscopic Approach

San Francisco, CA USA ( Zachary Kozel, MD of the Arthur Smith Institute for Urology at Northwell Health presented a moderated poster of their experience with laparoscopic completion nephrectomy following locoregional renal cell carcinoma (RCC) recurrence.

They conducted a retrospective review of patients who underwent extirpative therapy for RCC recurrence at their high-volume, tertiary-care center between 2006 and 2016. They excluded patients with solitary kidneys, benign pathology, or familial RCC. Local recurrence was defined as a new lesion seen on imaging either within or adjacent to the prior partial nephrectomy bed, and was confirmed by pathology.

Their final analytical cohort included 33 patients. Of these patients, 12 (36%) required conversion to open nephrectomy due to failure to progress (50%) and intraoperative hemorrhage (42%). Higher R.E.N.A.L nephrometry scores and the presence of metastatic disease were found to be significantly associated with conversion to open nephrectomy.

They concluded that laparoscopic completion nephrectomy for locoregional RCC recurrence is feasible, but associated with high rates of open conversion especially in cases with high nephrometry scores and the presence of metastatic disease.

Presented by: Zachary Kozel, MD

Written by: Michael Owyong, Department of Urology, University of California-Irvine at the 2018 AUA Annual Meeting - May 18 - 21, 2018 – San Francisco, CA USA