Adenocarcinoma of the kidney: nephron-sparing surgical approach vs. radical nephrectomy.
OBJECTIVE
Radical nephrectomy has been the traditional surgical treatment for renal cell carcinoma in patients with a normally functioning contralateral kidney. The necessity for a less aggressive surgical approach has emerged in cases in which there is a need to preserve renal function.


METHODS
We retrospectively evaluated the records of 41 patients with localized, symptomless small renal masses (<5 cm) treated with nephron-sparing surgery (group A) and 48 patients matched for age, tumor location, size, and stage who were treated with radical nephrectomy (group B).


RESULTS
The 5-year cancer-specific survival rates were 97.5% and 98. 4% for the treated patients of groups A an B, respectively. No statistical association was found between cancer-specific survival and surgical approach, tumor stage, tumor location, or recurrence. The size of the primary tumor did not seem to influence the cause-specific survival. Local recurrence was observed in 3 patients (7.3%) who underwent partial nephrectomy. In our series, the overall incidence of multifocality was 10.4%.


CONCLUSIONS
We propose segmental renal resection for unifocal small adenocarcinoma of the kidney in preference to radical surgery as it is corroborated by the presented data.
Barbalias
G A
GA
Department of Urology, University of Patras, School of Medicine, Patras, Greece. GBARBAL@med.upatras.gr
Liatsikos
E N
EN
Tsintavis
A
A
Nikiforidis
G
G
D000230:Adenocarcinoma / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D000328:Adult; D000368:Aged; D006801:Humans; D007680:Kidney Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D008875:Middle Aged; D009392:Nephrectomy; D009399:Nephrons / Q000601:surgery*; D012189:Retrospective Studies; D015996:Survival Rate