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Multicentricity in renal cell carcinoma

I Nissenkorn1, J Bernheim

  • 1Department of Urology, Meir General Hospital, Kfar Saba, Tel-Aviv, Israel.

The Journal of Urology
|March 1, 1995
PubMed
Summary

Radical nephrectomy may overtreat many small renal cell carcinoma cases. Partial nephrectomy is a viable alternative for small tumors when the other kidney is healthy, reducing overtreatment risks.

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Area of Science:

  • Urology
  • Oncology
  • Nephrology

Background:

  • Modern imaging detects over 50% of renal cell carcinomas incidentally, often as small tumors.
  • Radical nephrectomy is standard for renal cell carcinoma, even with a healthy contralateral kidney.
  • Concerns about satellite tumors have historically limited conservative surgery for renal cell carcinoma.

Purpose of the Study:

  • To evaluate the incidence of multicentric renal neoplasms.
  • To determine if partial nephrectomy is a safe and effective alternative to radical nephrectomy for small renal cell carcinomas.

Main Methods:

  • Analysis of 50 kidneys: 27 with renal cell carcinoma and 23 normal autopsied kidneys.
  • Assessment of small renal cell carcinoma incidence in kidneys with tumors.
  • Evaluation of small nodule incidence in normal kidneys.

Main Results:

  • Small renal cell carcinoma incidence was 11.1% in kidneys with tumors.
  • Small nodules (non-malignant) occurred in 13% of normal kidneys.
  • Satellite malignant nodules in small renal cell carcinoma (≤3 cm) were 3.7% in this series, comparable to other studies.

Conclusions:

  • Up to 100% of patients with small renal cell carcinoma (≤3 cm) may be overtreated with radical nephrectomy.
  • Partial nephrectomy should be widely considered for small renal cell carcinoma in patients with a normal contralateral kidney.

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