title: Nephron-sparing surgery of renal cell carcinoma with a normal opposite kidney: long-term outcome in 180 patients.
abstract: OBJECTIVE
  To investigate the long-term outcome of an organ-saving approach for renal cell carcinoma (RCC) with a normal opposite kidney (elective indication).
  
  
  METHODS
  Since 1979, 180 patients have undergone nephron-sparing surgery at our institution for RCC in the presence of a normal contralateral kidney. The mean age was 56 years (range 23 to 83), and the mean follow-up was 4.7 years (maximum 14. 8). Most of these tumors were found incidentally, with a mean tumor diameter on ultrasound of 3.3 cm (range 1.0 to 8.6).
  
  
  RESULTS
  The postoperative course was unremarkable in 173 patients. Postoperative bleeding was encountered in 4 patients and urinary extravasation in an additional 3 patients. No surgical reintervention was necessary. One hundred seventy-five RCCs were pT1 and 5 were pT3a; 73 were grade 1, 100 grade 2, and 7 were grade 3. The mean tumor diameter (surgical specimen) was 3.2 cm (range 0.5 to 7). In 132 cases, the tumor was less than 4 cm and in 48 cases, greater than 4 cm. Three patients experienced local tumor recurrence (1.6%) during follow-up, and two others developed distant metastases. The 5-year tumor-specific survival rate was 98.0%.
  
  
  CONCLUSIONS
  Nephron-sparing surgery for RCC under an elective indication in selected patients offers excellent long-term survival and an acceptably low local tumor recurrence rate. These results support the concept of nephron-sparing surgery in the presence of a normal contralateral kidney.
authors.affiliation: Department of Urology, Johannes Gutenberg University School of Medicine, Mainz, Germany.
authors.forename: D
authors.initials: D
authors.lastname: Filipas
authors.forename: J
authors.initials: J
authors.lastname: Fichtner
authors.forename: C
authors.initials: C
authors.lastname: Spix
authors.forename: P
authors.initials: P
authors.lastname: Black
authors.forename: W
authors.initials: W
authors.lastname: Carus
authors.forename: R
authors.initials: R
authors.lastname: Hohenfellner
authors.forename: J W
authors.initials: JW
authors.lastname: Thüroff
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002292:Carcinoma, Renal Cell / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007680:Kidney Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy / Q000379:methods; D011183:Postoperative Complications; D015996:Survival Rate; D016896:Treatment Outcome