The 2014 guideline has been up date d by a multidisciplinary panel using the highest method ological st and ards , and provides the best and most reliable contemporary evidence base for RCC management .
CONTEXT The European Association of Urology Guideline Panel for Renal Cell Carcinoma ( RCC ) has prepared evidence -based guidelines and recommendations for RCC management .
OBJECTIVES To provide an up date of the 2010 RCC guideline based on a st and ardised methodology that is robust , transparent , reproducible , and reliable .
Comparison of 1,800 laparoscopic and open partial nephrectomies for single renal tumors.
PURPOSE Laparoscopic partial nephrectomy is an increasingly performed , minimally invasive alternative to open partial nephrectomy . We compared early postoperative outcomes in 1,800 patients undergoing open partial nephrectomy by experienced surgeons with the initial experience with laparoscopic partial nephrectomy in patients with a single renal tumor 7 cm or less . MATERIAL S AND METHODS Data on 1,800 consecutive open or laparoscopic partial nephrectomies  were collected prospect ively or retrospectively in tumor registries at 3 large referral centers . Demographic , intraoperative , postoperative and followup data were compared between the 2 groups . RESULTS Compared to the  laparoscopic partial nephrectomy group of 771 patients the 1,028 undergoing open partial nephrectomy  were a higher risk group with a greater percent presenting symptomatically with decreased performance status , impaired renal function and tumor in a solitary functioning kidney ( p<0.0001 ) . More tumors in the open partial nephrectomy group were more than 4 cm and central ly located and more proved to be malignant ( p<0.0001 and 0.0003 , respectively ) . Based on multivariate analysis laparoscopic partial nephrectomy was associated with shorter operative time ( p<0.0001 ) , decreased operative blood loss ( p<0.0001 ) and shorter hospital stay ( p<0.0001 ) . The chance of intraoperative complications was comparable in the 2 groups . However , laparoscopic partial nephrectomy was associated with longer ischemia time ( p<0.0001 ) , more postoperative complications , particularly urological ( p<0.0001 ) , and an increased number of subsequent procedures ( p<0.0001 ) . Renal functional outcomes were similar 3 months after laparoscopic and open partial nephrectomy with 97.9 % and 99.6 % of renal units retaining function , respectively . Three-year cancer specific survival for patients with a single cT1N0M0 renal cell carcinoma was 99.3 % and 99.2 % after laparoscopic and open partial nephrectomy , respectively . CONCLUSIONS Early experience with laparoscopic partial nephrectomy is promising . Laparoscopic partial nephrectomy offered the advantages of less operative time , decreased operative blood loss and a shorter hospital stay . When applied to patients with a single renal tumor 7 cm or less , laparoscopic partial nephrectomy was associated with additional postoperative morbidity compared to open partial nephrectomy . However , equivalent functional and early oncological outcomes were achieved
The 2014 guideline has been up date d by a multidisciplinary panel using the highest method ological st and ards , and provides the best and most reliable contemporary evidence base for RCC management .
CONTEXT The European Association of Urology Guideline Panel for Renal Cell Carcinoma ( RCC ) has prepared evidence -based guidelines and recommendations for RCC management .
OBJECTIVES To provide an up date of the 2010 RCC guideline based on a st and ardised methodology that is robust , transparent , reproducible , and reliable .