[Does the surgical approach used for radical nephrectomy change the prognosis of renal carcinoma?].

To determine the influence of the surgical approach on survival, we conducted a retrospective study in 133 patients with renal carcinoma stage T1-T3 N0 M0 (UICC classification, 1987) submitted to radical nephrectomy. Overall no significant difference was observed in the 5 and 10-year survival rates for the different approaches (lumbotomy, transperitoneal laparotomy and thoracophrenolaparotomy). The 10-year survival rate for the cases with tumor stage T1-T2 varied significantly according to the approach: Thoracoabdominal (100%), lumbotomy (60%) and laparotomy (40%). No difference was observed for those with tumor stage T3a. For T3b the survival rate was higher for the lumbotomy approach and a significant difference was observed versus thoracophrenolaparotomy. The results show that the surgical approach does not influence the prognosis of renal carcinoma and choice depends on tumor size, location and invasion of the renal vein and/or vena cava.