H Van Poppel1, B Bamelis, R Oyen, L Baert. 1. Department of Urology, University Hospital Gasthuisberg and Katholieke Universiteit Leuven, Belgium.
Abstract
PURPOSE: Partial nephrectomy is becoming more widely accepted as alternative treatment for small renal cell carcinoma. To analyze its value in tumor control and its complication rate a retrospective study was done. MATERIALS AND METHODS: A total of 76 patients underwent kidney sparing surgery, which was required in 25 and in the presence of a normal contralateral kidney in 51. Tumor size varied between 0.9 and 15 cm. Simple enucleation was done in 4 and partial nephrectomy in all other cases. The patients were followed every 3 months during year 1, every 4 months during years 2 and 3, and every 6 months during years 4 and 5 postoperatively. Mean followup is 75 months. RESULTS: Eight patients had postoperative complications, most often hemorrhage. None of the patients had local recurrence, although in 3 systemic disease developed. CONCLUSIONS: Nephron sparing surgery is more challenging than radical nephrectomy and, therefore, can be more complicated. The selection of suitable candidates is the key to success. Many patients can benefit from nephron sparing surgery for small easily resectable renal cell carcinoma even in presence of a normal contralateral kidney. Randomized trials are needed to establish the definitive role of this approach in kidney cancer treatment.
PURPOSE: Partial nephrectomy is becoming more widely accepted as alternative treatment for small renal cell carcinoma. To analyze its value in tumor control and its complication rate a retrospective study was done. MATERIALS AND METHODS: A total of 76 patients underwent kidney sparing surgery, which was required in 25 and in the presence of a normal contralateral kidney in 51. Tumor size varied between 0.9 and 15 cm. Simple enucleation was done in 4 and partial nephrectomy in all other cases. The patients were followed every 3 months during year 1, every 4 months during years 2 and 3, and every 6 months during years 4 and 5 postoperatively. Mean followup is 75 months. RESULTS: Eight patients had postoperative complications, most often hemorrhage. None of the patients had local recurrence, although in 3 systemic disease developed. CONCLUSIONS: Nephron sparing surgery is more challenging than radical nephrectomy and, therefore, can be more complicated. The selection of suitable candidates is the key to success. Many patients can benefit from nephron sparing surgery for small easily resectable renal cell carcinoma even in presence of a normal contralateral kidney. Randomized trials are needed to establish the definitive role of this approach in kidney cancer treatment.
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