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[Intrarenal small tumor of the kidney]
Abstract:
From 1992 to 2002 four hundred and thirty-six patients with kidney tumors were treated. Tumor up to 4 cm ("small" tumor of the kidney) was diagnosed in 143 patients. Intrarenal localization of the tumor was in 35 (24.5%) of them. Two groups of patients with intrarenal tumor were are distinguished: tumor is localized intrasinusly whole (18 patients) or closer to fibrous capsule of the kidney (17 patients). In the majority of cases (31 patients) of small intrarenal tumor radical nephrectomy was performed. Four patients with absolute and relative indications to organ-saving surgery underwent nephrotomy and enucleoresection of an intrasinus tumor. Renal-cell cancer was in 3 of these patients, angiomyolipoma--in 1. All 3 patients with renal cancer are alive in follow-up for 7, 2 and 1.5 years.
Insights
Organ-sparing surgery for small intrarenal tumors, including renal cell cancer, shows promising survival rates. Nephrotomy and enucleoresection offer effective treatment options for select kidney tumor cases.
Area of Science:
- Urology
- Nephrology
- Surgical Oncology
Background:
- Kidney tumors are a significant clinical concern.
- Small tumors (up to 4 cm) represent a subset requiring specific management strategies.
- Intrarenal tumor localization influences surgical approach.
Purpose of the Study:
- To evaluate the outcomes of organ-sparing surgery for small intrarenal tumors.
- To assess the efficacy of nephrotomy and enucleoresection for intrasinus tumors.
- To analyze the follow-up results for patients treated with these techniques.
Main Methods:
- Retrospective analysis of 436 patients treated for kidney tumors from 1992-2002.
- Focus on 143 patients diagnosed with small kidney tumors (≤4 cm).
- Detailed review of surgical procedures (radical nephrectomy, nephrotomy, enucleoresection) and patient outcomes.
Main Results:
- 35 patients had intrarenal tumors, with 18 intrasinus and 17 near the capsule.
- 31 patients with small intrarenal tumors underwent radical nephrectomy.
- Four patients had nephrotomy and enucleoresection for intrasinus tumors; 3 with renal cell cancer and 1 with angiomyolipoma are alive after follow-up.
Conclusions:
- Organ-sparing surgery, including nephrotomy and enucleoresection, is a viable option for selected small intrarenal tumors.
- These techniques demonstrate favorable outcomes, particularly for renal cell cancer and angiomyolipoma.
- Careful patient selection is crucial for successful organ-sparing kidney tumor treatment.