Tumor Enucleation for Renal Cell Carcinoma

Area of Science:

• Urology
• Oncology
• Surgical Innovation

Background:

• Increasing detection of small renal masses (SRMs) drives demand for nephron-sparing surgery (NSS).
• NSS techniques aim to preserve renal parenchyma while matching oncologic outcomes of radical nephrectomy (RN).
• Partial nephrectomy (PN) offers renal and survival benefits over RN, but further parenchyma preservation is sought.

Purpose of the Study:

• To review literature on simple enucleation (SE) for SRMs.
• To advocate for SE as a routine NSS consideration.
• To compare SE with traditional PN for small renal masses.

Main Methods:

• Literature review of studies comparing SE and PN for SRMs.
• Analysis of oncologic outcomes, including positive surgical margins.
• Evaluation of long-term progression-free and cancer-specific survival rates.

Main Results:

• SE demonstrates oncological safety comparable to PN for SRMs.
• SE is associated with a lower incidence of positive surgical margins.
• SE shows similar 5- and 10-year progression-free and cancer-specific survival rates as PN.

Conclusions:

• Simple enucleation (SE) is an effective nephron-sparing surgery (NSS) for small renal masses (SRMs).
• SE preserves maximal renal parenchyma with oncologic outcomes similar to partial nephrectomy (PN).
• SE should be routinely considered for renal tumors amenable to NSS.