Partial Nephrectomy for Renal Cell Carcinoma: Indications, Results and Implications

Abstract

Of 52 patients who underwent partial nephrectomy for tumor 44 were found to have renal cell carcinoma. The indications for this parenchyma-sparing procedure were categorized according to the initial status of the contralateral kidney and included bilateral tumors or tumor in a solitary kidney in 16 patients (mandatory indications), unilateral carcinoma with compromise of the contralateral kidney by a benign disease process in 9 (relative indications) and small peripheral tumor with a normal contralateral kidney in 19 (elective indications). There were 4 recurrences that accounted for 3 deaths, all in patients with mandatory indications. All patients who underwent partial nephrectomy for relative or elective indications were without definite evidence of recurrent disease at last followup (over-all mean 36 months). Our results suggest that conservative surgery can often provide effective and advantageous therapy for renal cancer and we encourage further consideration of the role of partial nephrectomy as an alternative to radical nephrectomy in selected patients with small peripheral tumors and normal contralateral kidneys.

Laparoscopic Surgery for Stage T1 Renal Cell Carcinoma: Radical Nephrectomy and Wedge Resection

“…Traditionally, partial nephrectomy for RCC was performed only with tumours occurring in a solitary kidney [34, 35, 36]. Owing to the widespread use of sonography and computerized tomography, an increasing number of small lesions are incidentally found [37].…”

Renal Cell Carcinoma: Evaluation of the 1997 TNM System and Recommendations for Follow–Up after Surgery

“…This improvement has occurred despite the conversion from radical nephrectomy to nephron–sparing surgery as the standard therapy for small RCC [2]. In recent articles that have included a total of 1,088 patients who underwent nephron–sparing surgery for RCC, disease free survival was 90–100% after a mean follow–up of 31–78 months, and there were only 23 cases (2.1%) of local recurrence [1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14]. …”

Effects of Perfusion on Radiofrequency Ablation in Swine Kidneys

“…The treatment of renal cell carcinoma has greatly improved owing to advances in imaging modalities and surgical techniques (4,5), with the present reference-standard technique for treatment of renal tumors being radical nephrectomy. However, small localized renal tumors have also been successfully treated with partial nephrectomy (6)(7)(8)(9)(10)(11)(12). A minimally invasive treatment capable of causing the selective destruction of large tumors while preserving kidney function might have a positive effect on the outcomes of quality of life and dialysis-free survival.…”