Laparoscopic partial nephrectomy for multilocular cystic renal cell carcinoma: a potential gold standard treatment with excellent perioperative outcomes

BACKGROUND: To report on the perioperative outcomes of laparoscopic partial nephrectomy (LPN) for multilocular cystic renal cell carcinoma (MCRCC) and evaluate the feasibility of this minimally invasive technique as a potential gold standard treatment for MCRCC. METHODS: We retrospectively reviewed the database of surgically pathological findings of patients who were diagnosed with MCRCC at Peking University First Hospital and Chinese PLA General Hospital (Beijing, China) between May 2009 and January 2013. A total of 42 patients with an average age of 48.3 years who were treated with LPN were collected. The patients’ perioperative outcomes were reported and analyzed. RESULTS: All operations were performed successfully without massive hemorrhage or open conversion. None of patients received lymph node dissection or metastasectomy. Two patients required postoperative transfusion with a mean amount of 175 cc packed red blood cells. Only three patients experienced mild postoperative complications. The mean operative time was 2.4 ± 1.2 hours, including the mean warm ischemia time (WIT) of 23.2 ± 5.7 minutes. The mean estimated blood loss was 72.0 ± 49.6 ml. The mean retroperitoneal drainage was 4.4 ± 1.7 days. The mean postoperative hospital stay was 6.1 ± 1.9 days. Pathologically, 40 (95.2%) of the tumors presented as stage pT1abN0M0, while the remaining two (4.8%) presented as stage pT2aN0M0. No recurrences or new lesions occurred in these patients at a mean follow-up time of 30.0 months. CONCLUSIONS: Although the effective option of LPN is not yet the gold standard treatment for conventional renal cell carcinoma, it should be strongly recommended as a potential gold standard treatment for MCRCC due to the benign nature of MCRCC and the excellent perioperative outcomes provided by LPN.