Clinical experience with nephron-sparing surgery in the presence of a normal contralateral kidney.

Since 1981, 110 patients have undergone a nephron-sparing surgery for renal cell carcinoma in the presence of normal contralateral kidney (elective indication) at our institution. The majority of these tumors were incidental findings with a mean tumor diameter of 3.3 cm (range 1 to 7 cm). After a mean follow-up period of 50.6 months, 1 patient died of metastatic disease, 5 died of tumor-unrelated causes, 2 are alive with systemic progression, and 102 are alive with no evidence of disease, resulting in a 5-year cancer specific survival rate of 98%. During the follow-up period, local tumor recurrence occurred in 3 patients (2.7%) without evidence of systemic progression at the time of diagnosis. A repeated nephron-sparing surgery (1 patient) or total excision of the renal remnant (2 patients) was possible in all these cases. Our results suggest that nephron-sparing surgery provides effective curative treatment for patients with small, unilateral, single, and localized renal cell carcinoma.