Authors' Response to Letter to the Editor: Re: Laparoscopic Resection of Local Recurrence After Previous Radical Nephrectomy for Clinically Localized Renal-Cell Carcinoma: Perioperative Outcomes and Initial Observations ( Citation: Tsivian A,Tsivian M,and Sidi AA,J Endourol 2011;25:705)

Dear Editor:

W e thank Tsivian and colleagues ¹ for their interest in our article regarding the laparoscopic resection of local recurrence after previous radical nephrectomy for localized renal cell carcinoma. Our manuscript was prepared prior to the publication of their report and we commend them on reporting their experience in 2006 and 2009. In our opinion, a local recurrence is defined as pathologically proven renal cell carcinoma in the renal fossa, ipsilateral adrenal gland, or ipsilateral retroperitoneal lymph nodes. This definition is not unique to our study and has been previously used in other larger reports. ² There is no consensus in the oncological community regarding the extent of resection in this setting and all of the recurrences in our study were resected with negative surgical margins. The implication by Tsivian and colleagues that this deviates from what would be done during open surgery is conjecture at best.