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Parenchyma-conserving surgery for renal cell carcinoma
K Taari1, J O Salo, S Rannikko
1Department of Urology, Helsinki University Central Hospital, Finland.
Annales Chirurgiae Et Gynaecologiae. Supplementum
|January 1, 1993
Summary
Conservative surgery for renal cell carcinoma (RCC) is a viable option for small kidney tumors. While elective partial nephrectomy offers excellent survival, imperative cases show lower survival rates due to tumor complexity.
Area of Science:
- Urology
- Oncology
- Nephrology
Background:
- Renal cell carcinoma (RCC) management has evolved, with increasing interest in kidney-sparing surgical techniques.
- Partial nephrectomy and enucleation represent conservative surgical approaches for RCC.
Purpose of the Study:
- To evaluate the outcomes of conservative surgery for renal cell carcinoma (RCC) between 1969 and 1992.
- To compare the results of elective versus imperative parenchyma-conserving surgery for RCC.
Main Methods:
- Retrospective analysis of 32 patients who underwent conservative surgery (partial nephrectomy or enucleation) for RCC.
- Patients were divided into elective (small, peripheral tumors, normal contralateral kidney) and imperative (solitary kidney, bilateral tumors, renal insufficiency) groups.
- Follow-up ranged from 0.2 to 192 months.
Main Results:
- The elective group (n=10) had tumors ranging from 15-100 mm (mean 37 mm) with no cancer-related deaths and a 5-year cause-specific survival rate of 100%.
- The imperative group (n=22) had tumors ranging from 5-200 mm (mean 41 mm), with 41% mortality from RCC and a 5-year cause-specific survival rate of 46%.
- Local recurrences occurred in 3 of 22 imperative cases, two associated with von Hippel-Lindau disease.
Conclusions:
- Conservative surgery, particularly partial nephrectomy, is a feasible and effective option for selected patients with small, peripheral renal cell carcinoma.
- Outcomes differ significantly between elective and imperative indications, with higher risks in the latter group.