Contemporary Experience with Partial Nephrectomy for Stage T2 or Greater Renal Tumors

The purpose of this paper is to review current studies on the topic of partial nephrectomy (PN) for renal masses stage T2 and greater. We conducted a PubMed literature review of English language articles published from 2000 onward. Eight studies were selected for this review including 359 PN patients. Median tumor size was 7.5 to 8.7, and tumor histology was mainly clear cell. Technique was mainly open, the reported median ischemia time was 29-45 min, and median operative time 170-221 min. Positive margin rates were 0-31%. On a median follow-up range of 13.1 to 70 months, 5-year progression-free survival was 71-92.5%, and 5-year overall survival was 66-94.5% in the study populations. There is limited retrospective evidence in favor of preserved oncologic efficacy in patients with renal tumors larger than 7 cm in size treated with nephron-sparing surgery. This review emphasizes the need for more studies and long-term follow-up data to determine the proper role of partial nephrectomy in large kidney tumors.