International journal of urology : official journal of the Japanese Urological Association
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Review Meta Analysis
The role of cytoreductive nephrectomy in the era of molecular targeted therapy.
While the widespread use of imaging has resulted in an increasing number of incidentally detected renal cancers, up to one third of patients present with metastatic disease and a significant number of those with clinically localized disease subsequently develop metastasis. The prognosis for patients with metastatic disease has traditionally been poor, with a 2-year survival of only 10 to 20%. ⋯ Meanwhile, the recent introduction of molecular targeted agents has resulted in improved response rates and tolerability compared with immunotherapy, and has prompted a re-evaluation of the role and timing of surgery in patients with advanced disease. This review examines the role of surgical therapy for patients with metastatic disease in the new era of molecular targeted therapy.
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To compare perioperative outcome of transperitoneal and retroperitoneal approaches during laparoscopic radical nephrectomy (LRN) and to identify selection criteria for each approach. ⋯ Retroperitoneal and transperitoneal approaches yielded excellent surgical outcomes. The transperitoneal approach should be chosen based on tumor size and location to minimize vascular injury.