[Organ preserving surgery in kidney tumors]

Between 1967 and 1989 102 patients underwent conservative surgery for renal tumors at the Department of Urology, Mainz Medical School. In 39 patients the indication for organ preserving surgery was imperative because of single kidney, bilateral tumors, benign pathology of the contralateral kidney or chronic renal failure. In the elective group 63 patients underwent tumor enucleation for small, peripheral lesions of uncertain dignity. Tumors removed for imperative indications varied in diameter from 2-11 cm (mean 5.5 cm) whereas those which were electively resected ranged from 1-7 cm (mean 3.2 cm). 74% of the electively enucleated tumors were detected in an early asymptomatic stage by routine ultrasound investigations. 58 of the 63 patients with elective indications are alive with no evidence of tumor after a mean follow-up of 35 months (5-90 months). One patient was lost to follow-up, 3 patients died of reasons unrelated to cancer, and only 1 patient died of progressive disease. These results indicate, that tumor enucleation is a safe and reliable technique in small, peripheral renal tumors and offers an adequate alternative to radical nephrectomy in selected patients.