Department of Urology, Shanghai Tenth People's Hospital, Tongji University, Shanghai 200072, China.
Chin Med J (Engl). 2013;126(15):2938-42.
Most of the literatures on laparoscopic partial nephrectomy (LPN) versus open partial nephrectomy (OPN) focus on technical details and early or mid-term oncologic outcomes, reflecting that the approach is safe and provides midterm benefits compared with traditional open surgery. However, the difference of long-term oncologic outcome between LPN and OPN remains unclear. The aim of this meta-analysis was to evaluate the long-term oncologic outcome of LPN in the treatment of localized renal tumors compared with that of OPN.
A systematic search of electronic databases including Medline, Embase, and Cochrane library was conducted. Comparative studies reporting on long-term oncologic outcome of LPN versus OPN were regarded eligible. The odds ratio (OR) and its corresponding 95% confidence intervals (CI) were calculated for the oncologic outcomes. The methodologic quality of the included studies was evaluated using the strict criteria of the Newcastle-Ottawa scale.
Six comparative studies (1495 participants including 555 LPN and 940 OPN) were included in the present study. There was no significant difference between LPN and OPN in 5-year overall survival (OS) rates (OR = 1.83, 95% CI (0.80, 4.19)), 5-year cancer specific survival (CSS) rates (OR = 1.09, 95% CI (0.62, 1.92)), and 5-year recurrence free survival (RFS) rates (OR = 0.68, 95% CI (0.37, 1.26)).
The results of this meta-analysis revealed that there was no significant difference in long-term oncologic outcome between LPN and OPN for treatment of localized renal tumors.
大多数关于腹腔镜部分肾切除术(LPN)与开放部分肾切除术(OPN)的文献都集中在技术细节和早期或中期肿瘤学结果上,这反映出该方法与传统开放手术相比是安全的,并且提供了中期获益。然而,LPN 和 OPN 的长期肿瘤学结果之间的差异仍不清楚。本荟萃分析的目的是评估 LPN 治疗局限性肾肿瘤的长期肿瘤学结果与 OPN 的差异。
系统检索了包括 Medline、Embase 和 Cochrane 图书馆在内的电子数据库。将报告 LPN 与 OPN 比较的长期肿瘤学结果的对照研究视为合格研究。使用纽卡斯尔-渥太华量表的严格标准评估纳入研究的方法学质量。
本研究纳入了 6 项对照研究(1495 名参与者,包括 555 名 LPN 和 940 名 OPN)。LPN 和 OPN 在 5 年总生存率(OS)率(OR=1.83,95%CI(0.80,4.19))、5 年癌症特异性生存率(CSS)率(OR=1.09,95%CI(0.62,1.92))和 5 年无复发生存率(RFS)率(OR=0.68,95%CI(0.37,1.26))方面无显著差异。
本荟萃分析结果表明,对于治疗局限性肾肿瘤,LPN 和 OPN 的长期肿瘤学结果无显著差异。