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Guo X, Wang H, Xiang Y, Jin X, Jiang S. Safety and oncological outcomes for large (stage ≥T2b) and locally advanced renal cell carcinoma: comparison between laparoscopic and modified hand-assisted laparoscopic radical nephrectomy. J Int Med Res 2020; 48:300060520961238. [PMID: 33044120 PMCID: PMC7556169 DOI: 10.1177/0300060520961238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Objective To compare the operative and oncologic outcomes between hand-assisted laparoscopic radical nephrectomy (HALRN) and laparoscopic radical nephrectomy (LRN) for large (stage ≥T2b) and locally advanced renal cell carcinoma. Methods We retrospectively collected data from patients who underwent HALRN or LRN for stage ≥T2b renal cell carcinoma from January 2011 to January 2018 in our institution. The patients’ demographics, perioperative parameters, and postoperative follow-up data were compared between the two groups. The survival outcome was estimated using the Kaplan–Meier method. Results The HALRN group comprised 78 patients, and the LRN group comprised 63 patients. The median operative duration was significantly shorter in the HALRN than LRN group. The two groups were equivalent in terms of the incision length, blood loss, complication rate, and duration of hospitalization. In the HALRN and LRN groups, the 5-year overall survival rates were 69.4% and 73.1%, the 5-year cancer-specific survival rates were 80.0% and 83.3%, and the 5-year progression-free survival rates were 66.4% and 74.7%, respectively, with no significant differences. Conclusions Compared with LRN, HALRN may offer a shorter operative duration and equivalent surgical outcomes without sacrificing oncological efficacy. In addition, HALRN has specific advantages for extremely large and complicated renal tumors.
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Affiliation(s)
- Xudong Guo
- Department of Urology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China.,Department of Urology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
| | - Hanbo Wang
- Department of Urology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
| | - Yuzhu Xiang
- Department of Urology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
| | - Xunbo Jin
- Department of Urology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
| | - Shaobo Jiang
- Department of Urology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
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Knight BA, Potretzke AM, Larson JA, Bhayani SB. Comparing Expert Reported Outcomes to National Surgical Quality Improvement Program Risk Calculator-Predicted Outcomes: Do Reporting Standards Differ? J Endourol 2015; 29:1091-9. [DOI: 10.1089/end.2015.0178] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Affiliation(s)
- B. Alexander Knight
- Division of Urologic Surgery, Washington University School of Medicine, St. Louis, Missouri
| | - Aaron M. Potretzke
- Division of Urologic Surgery, Washington University School of Medicine, St. Louis, Missouri
| | - Jeffrey A. Larson
- Division of Urologic Surgery, Washington University School of Medicine, St. Louis, Missouri
| | - Sam B. Bhayani
- Division of Urologic Surgery, Washington University School of Medicine, St. Louis, Missouri
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Ito K. Editorial Comment from Dr Ito to Long-term outcome of hand-assisted laparoscopic radical nephrectomy for T1 renal cell carcinoma. Int J Urol 2014; 21:1097. [PMID: 25099272 DOI: 10.1111/iju.12593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Keiichi Ito
- Department of Urology, National Defense Medical College, Tokorozawa, Saitama, Japan.
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Hongo F, Kawauchi A, Ueda T, Fujihara A, Naitoh Y, Nakamura T, Naya Y, Kamoi K, Okihara K, Miki T. Long-term outcome of hand-assisted laparoscopic radical nephrectomy for T1 renal cell carcinoma. Int J Urol 2014; 21:1093-6. [PMID: 25040625 DOI: 10.1111/iju.12551] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2013] [Accepted: 06/04/2014] [Indexed: 12/01/2022]
Abstract
OBJECTIVES To investigate the long-term outcomes of hand-assisted laparoscopic radical nephrectomy compared with those of open nephrectomy. METHODS Hand-assisted laparoscopic radical nephrectomy was carried out in 132 patients with T1 renal cell carcinoma (between November 1999 and November 2008). Their outcomes were compared with those of 61 patients treated with open nephrectomy. The durations of follow up were 6-121 months (median 65 months) and 7-146 months (median 84 months) in the hand-assisted laparoscopic radical nephrectomy and open nephrectomy groups, respectively. RESULTS The 7-year recurrence-free rates were 88.5 and 85.6% in the hand-assisted laparoscopic radical nephrectomy and open nephrectomy groups, respectively, showing no significant difference between the two groups. The 7-year cancer-specific survival rates were 92.3 and 91.4% in the hand-assisted laparoscopic radical nephrectomy and open nephrectomy groups, respectively, showing no significant difference between the two groups. Also, the 10-year recurrence-free rates were 85.4 and 78.1% in the hand-assisted laparoscopic radical nephrectomy and open nephrectomy groups, respectively. When changes in the recurrence-free rate were analyzed using the Kaplan-Meier method, no significant difference was observed between the two groups. The 10-year cancer-specific survival rates were 91.8 and 87.9% for hand-assisted laparoscopic radical nephrectomy and open nephrectomy, respectively, showing no significant difference between the groups. CONCLUSIONS Hand-assisted laparoscopic radical nephrectomy might be comparable with open nephrectomy with regard to long-term cancer control.
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Affiliation(s)
- Fumiya Hongo
- Department of Urology, Kyoto Prefectural University of Medicine, Kyoto, Japan
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Bansal RK, Tu HYV, Drachenberg D, Shayegan B, Matsumoto E, Whelan JP, Kapoor A. Laparoscopic management of advanced renal cell carcinoma with renal vein and inferior vena cava thrombus. Urology 2014; 83:812-6. [PMID: 24411219 DOI: 10.1016/j.urology.2013.09.060] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2013] [Revised: 08/25/2013] [Accepted: 09/27/2013] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To report the results and oncological efficacy of laparoscopic radical nephrectomy (LRN) in patients with renal cell carcinoma with renal vein and inferior vena cava thrombus. METHODS We performed retrospective record review of 41 patients who underwent LRN along with venous thrombectomy at 2 Canadian centers from 2002 to 2012 by dedicated laparoscopic surgeons. RESULTS The mean age and body mass index of the 41 study patients (34 males and 7 female) were 64.4 years and 28.7 kg/m(2), respectively. Median tumor size was 9.3 cm; 39 patients had renal vein thrombus, and 2 had inferior vena cava thrombus. Nine patients (22%) had metastatic disease to begin with and underwent laparoscopic cytoreductive nephrectomy. Median estimated blood loss, operative time, and length of stay were 100 mL (range, 50-400 mL), 134.5 minutes (range, 99-183 minutes), and 4 days (range, 4-6 days), respectively. There were 4 (9.7%) grade 2 complications. There was no intraoperative death. Mean duration of follow-up was 42 months (range, 6-107 months). Of 32 patients with localized disease, 4 (12.5%) died of progressive disease, 3 (9.3%) died of unrelated causes, and 3 patients (9.3%) were lost to follow-up. Twenty-two patients (68.7%) were alive at a mean follow-up of 47 months. CONCLUSION LRN and venous thrombectomy for advanced renal tumors with venous thrombus are safe procedures in experienced hands with significant laparoscopic skills. The short-term oncological data are encouraging and advocate the efficacy of this procedure in this subset of patients, although longer follow-up is required in larger number of patients to further define its role.
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Affiliation(s)
- Rahul Kumar Bansal
- McMaster Institute of Urology, St. Joseph's Healthcare, McMaster University, Hamilton, Ontario, Canada
| | - Hin Yu Vincent Tu
- McMaster Institute of Urology, St. Joseph's Healthcare, McMaster University, Hamilton, Ontario, Canada
| | - Darrel Drachenberg
- Department of Surgery, Section of Urology, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Bobby Shayegan
- McMaster Institute of Urology, St. Joseph's Healthcare, McMaster University, Hamilton, Ontario, Canada
| | - Edward Matsumoto
- McMaster Institute of Urology, St. Joseph's Healthcare, McMaster University, Hamilton, Ontario, Canada
| | - J Paul Whelan
- McMaster Institute of Urology, St. Joseph's Healthcare, McMaster University, Hamilton, Ontario, Canada
| | - Anil Kapoor
- McMaster Institute of Urology, St. Joseph's Healthcare, McMaster University, Hamilton, Ontario, Canada.
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Hung SF, Wang SM, Chung SD, Lai MK, Huang KH, Pu YS, Yu HJ, Huang CY. Long-term oncologic outcomes of hand-assisted retroperitoneoscopic radical nephrectomy to treat clinically localized renal cell carcinoma. J Formos Med Assoc 2012; 111:41-5. [PMID: 22333012 DOI: 10.1016/j.jfma.2012.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2010] [Revised: 04/06/2010] [Accepted: 10/12/2010] [Indexed: 10/14/2022] Open
Abstract
BACKGROUND/PURPOSE To evaluate the long-term oncological outcomes of hand-assisted retroperitoneoscopic radical nephrectomy (HARRN) for treating clinically localized renal cell carcinoma. METHODS We retrospectively collected and analyzed the data and clinical outcomes of 46 patients who underwent HARRN and 50 patients who underwent conventional open radical nephrectomy (ORN) at our institution for clinical localized renal cell carcinoma (RCC). RESULTS The median follow-up period of the HARRN group was 56.5 months (range: 14.6-78.7 months); for the ORN group, the median follow-up period was 110.8 months (range: 15.5-123 months). Patient age, sex, body mass index, pathologic parameters, and classification based on the guidelines of the American Society of Anesthesiologists were not significantly different between the two groups. The HARRN group had a significantly longer operative time (218 minutes vs. 178 minutes, p = 0.003) and less blood loss (203 mL vs. 670 mL, p < 0.001). The complication rates of the ORN and HARRN groups were similar (8% and 4.3%, respectively, p = 0.46). No conversions to an open procedure or intraoperative mortality occurred in the HARRN group. The disease-free and disease-specific survival rates were comparable between the two groups. CONCLUSION The results of our study indicate that HARRN is a feasible, minimally invasive treatment for managing clinically organ-confined RCC with a good long-term oncological outcome.
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Affiliation(s)
- Shun-Fa Hung
- Department of Urology, National Taiwan University Hospital and College of Medicine, National Taiwan University, Taipei, Taiwan
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Parker PA, Swartz R, Fellman B, Urbauer D, Li Y, Pisters LL, Rosser CJ, Wood CG, Matin SF. Comprehensive assessment of quality of life and psychosocial adjustment in patients with renal tumors undergoing open, laparoscopic and nephron sparing surgery. J Urol 2012; 187:822-6. [PMID: 22245327 DOI: 10.1016/j.juro.2011.10.151] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2011] [Indexed: 11/16/2022]
Abstract
PURPOSE We prospectively evaluated the general and cancer specific quality of life, and psychosocial adjustment of patients with a renal mass treated with radical vs partial nephrectomy via a laparoscopic or an open approach. MATERIALS AND METHODS A total of 172 patients with renal tumors completed questionnaires before surgery, and 3 weeks, and 2, 3, 6 and 12 months postoperatively. We assessed general quality of life using SF-36™ and cancer specific quality of life using the Cancer Rehabilitation Evaluation System-Short Form, in addition to intrusive thoughts, avoidance behaviors and fear of recurrence. We used mixed model regression analysis to compare these measures across surgery types during the study course, adjusted for tumor size, histology, stage and renal function. RESULTS The SF-36 physical component score differed significantly by surgery type with time (p = 0.04). Patients treated with laparoscopy improved by month 2 while those treated with open surgery had poorer quality of life until month 3. Better cancer specific quality of life was reported in patients who underwent radical vs partial nephrectomy. Age also had a significant effect on outcomes. CONCLUSIONS We report one of the most comprehensive patient reported prospective quality of life studies in patients with renal cell carcinoma. There were significant differences in quality of life and psychosocial adjustment outcomes during 1 year among patients treated with 1 of 4 commonly accepted surgical renal procedures. These outcomes must be evaluated in the context of tumor characteristics, cancer specific outcomes and renal function. These quality of life issues may be important to consider when choosing surgical procedures for patients with renal tumors.
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Affiliation(s)
- Patricia A Parker
- Department of Behavioral Science, University of Texas M.D. Anderson Cancer Center, Houston, Texas 77230-1439, USA.
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Hoang AN, Vaporcyian AA, Matin SF. Laparoscopy-Assisted Radical Nephrectomy with Inferior Vena Caval Thrombectomy for Level II to III Tumor Thrombus: A Single-Institution Experience and Review of the Literature. J Endourol 2010; 24:1005-12. [DOI: 10.1089/end.2009.0532] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Affiliation(s)
- An N. Hoang
- Division of Urology, Department of Surgery, The University of Texas Medical School at Houston, Houston, Texas
| | - Ara A. Vaporcyian
- Department of Thoracic Surgery, The University of Texas M. D. Anderson Cancer Center, Houston, Texas
| | - Surena F. Matin
- Department of Urology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas
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Gabr AH, Gdor Y, Strope SA, Roberts WW, Wolf JS. Approach and Specimen Handling Do Not Influence Oncological Perioperative and Long-Term Outcomes After Laparoscopic Radical Nephrectomy. J Urol 2009; 182:874-80. [DOI: 10.1016/j.juro.2009.05.034] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2009] [Indexed: 10/20/2022]
Affiliation(s)
- Ahmed H. Gabr
- Department of Urology, University of Michigan Health System, Ann Arbor, Michigan
| | - Yehoshua Gdor
- Department of Urology, University of Michigan Health System, Ann Arbor, Michigan
| | - Seth A. Strope
- Department of Urology, University of Michigan Health System, Ann Arbor, Michigan
| | - William W. Roberts
- Department of Urology, University of Michigan Health System, Ann Arbor, Michigan
| | - J. Stuart Wolf
- Department of Urology, University of Michigan Health System, Ann Arbor, Michigan
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Tobias-Machado M, Ravizzini PI, Pertusier LO, Pedroso E, Wroclawski ER. Prospective comparative study between retroperitoneoscopic and hand-assisted laparoscopic approach for radical nephrectomy. Int Braz J Urol 2009; 35:284-91; discussion 291-2. [PMID: 19538763 DOI: 10.1590/s1677-55382009000300004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/16/2009] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE No consensus has yet been established regarding the best minimally invasive access for radical ablation of renal tumors. Our objective was to prospectively compare the surgical results and oncologic management of two currently used endoscopic techniques. MATERIALS AND METHODS Over a four-year period, 50 patients with renal tumors and clinical stage T1b-T2, smaller than 12 cm, underwent a radical nephrectomy at two reference institutions, 25 underwent retroperitoneoscopic radical nephrectomy (RRN) and 25 a hand-assisted laparoscopic radical nephrectomy (HALRN). Mean follow-up of both cohorts was 50 months. Operative parameters and oncological management were compared. RESULTS The mean operative time was 180 min in RRN and 108 min in HALRN (p < 0.001). The time required to access the renal pedicle in RRN was 30 min. and in HALRN 40 min., Learning curve was shorter in HALRN than RRN. Mean blood loss was 100 mL in RRN and 242 mL in HALRN. Mean incision size for specimen retrieval in RRN was 6.5 cm and in HALRN 7.5 cm. One patient with intra operative occurrence of ascites and subsequent pathological stage pT2N0M0 grade 3 operated via HALRN, had neoplasic implants in the Hand-port incision 3 months after surgery followed by death 4 months after recurrence. One patient, with pathological stage pT3N0M0 grade 3 in RRN had metastasis after 36 months. CONCLUSION Both, RRN and HALRN techniques are accepted minimally invasive options for endoscopic radical nephrectomy with equivalent long term oncological outcome in the treatment of renal tumors.
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Affiliation(s)
- Marcos Tobias-Machado
- Division of Urologic Oncology and Laparoscopy, ABC Medical School, Santo Andre, Sao Paulo, Brazil.
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EORTC-GU group expert opinion on metastatic renal cell cancer. Eur J Cancer 2009; 45:765-73. [DOI: 10.1016/j.ejca.2008.12.010] [Citation(s) in RCA: 81] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2008] [Accepted: 12/12/2008] [Indexed: 11/18/2022]
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Box GN, Lehman DS, Landman J, Clayman RV. Minimally Invasive Management of Upper Tract Malignancies: Renal Cell and Transitional Cell Carcinoma. Urol Clin North Am 2008; 35:365-83, vii. [DOI: 10.1016/j.ucl.2008.05.010] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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Parker AS, Lewis R, Heckman MG, Diehl NH, Brisson T, Pak R, Wehle MJ. Evaluation of the Impact of Body Mass Index on Outcome among Renal Mass Patients Treated with Hand-Assisted Laparoscopic Radical Nephrectomy. J Endourol 2008; 22:301-6. [DOI: 10.1089/end.2007.0250] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Affiliation(s)
| | - Richard Lewis
- Department of Urology, Mayo Clinic Jacksonville, Jacksonville, Florida
| | - Michael G. Heckman
- Department of Biostatistics, Mayo Clinic Jacksonville, Jacksonville, Florida
| | - Nancy H. Diehl
- Department of Biostatistics, Mayo Clinic Jacksonville, Jacksonville, Florida
| | - Theodore Brisson
- Department of Urology, Mayo Clinic Jacksonville, Jacksonville, Florida
| | - Raymond Pak
- Department of Urology, Mayo Clinic Jacksonville, Jacksonville, Florida
| | - Michael J. Wehle
- Department of Urology, Mayo Clinic Jacksonville, Jacksonville, Florida
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Booth J, Matin SF, Ahrar K, Tamboli P, Wood CG. Contemporary strategies for treating nonhereditary synchronous bilateral renal tumors and the impact of minimally invasive, nephron-sparing techniques. Urol Oncol 2007; 26:37-42. [PMID: 18190828 DOI: 10.1016/j.urolonc.2007.01.012] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2006] [Revised: 01/02/2007] [Accepted: 01/04/2007] [Indexed: 10/22/2022]
Abstract
OBJECTIVES As surgical technology and expertise advance, treatment strategies for patients with bilateral renal tumors will continue to shift toward methods that maximize preservation of renal function and maintain optimal oncologic outcomes while minimizing morbidity. Reports about such strategies are limited. We report the outcome of a contemporary cohort of patients treated for nonhereditary synchronous bilateral renal tumors at our institution to evaluate surgical strategies and newer techniques used during patient treatment. METHODS From a surgical database, we identified 43 patients who met the criteria for nonhereditary, synchronous, bilateral renal tumors. Demographic characteristics, tumor pathology, renal function, surgical data, and outcomes were extracted from each patient's medical record. Computerized literature searches were performed to identify related articles for comparative purposes. RESULTS Of the 43 patients, 36 (82%) were treated with staged procedures a median of 54 days apart. A total of 23 patients (53.3%) received bilateral nephron-sparing therapy, of whom 11 underwent a minimally invasive nephron-sparing approach. There was a median 28.0 ml/min decrease in creatinine clearance between initial preoperative levels and at last follow-up, with a median follow-up duration of 16 months, and no patient required dialysis. Of the 43 patients, 2 (4.7%) had local recurrences, and 1 (2.3%) had metastatic disease. CONCLUSION These findings show a contemporary standard of care for treating patients with bilateral renal tumors, with more than half the patients undergoing bilateral nephron-sparing and nearly one third of patients receiving a minimally invasive nephron-sparing approach.
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Affiliation(s)
- James Booth
- Department of Urology, University of Texas M.D. Anderson Cancer Center, Houston, TX 77030, USA
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Bandi G, Christian MW, Hedican SP, Moon TD, Nakada SY. Oncological outcomes of hand-assisted laparoscopic radical nephrectomy for clinically localized renal cell carcinoma: a single-institution study with >or=3 years of follow-up. BJU Int 2007; 101:459-62. [PMID: 17941924 DOI: 10.1111/j.1464-410x.2007.07235.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To evaluate the intermediate-term outcomes of hand-assisted laparoscopic radical nephrectomy (HALRN) for clinically organ-confined renal cell carcinoma (RCC). PATIENTS AND METHODS 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 >or=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. RESULTS 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 >or=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. CONCLUSION Our study suggests that HALRN is a safe and minimally invasive treatment for managing clinically organ-confined RCC, with good intermediate-term oncological outcomes.
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Affiliation(s)
- Gaurav Bandi
- Division of Urology, Department of Surgery, University of Wisconsin Medical School, Madison, WI 53792, USA
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