Nephron-sparing surgery for localized renal cell carcinoma with a normal contralateral kidney: a European three-center experience.
OBJECTIVE
To assess the long-term effectiveness and safety of nephron-sparing surgery for the treatment of localized renal cell carcinoma with a normal contralateral kidney.


METHODS
Since 1973, 118 patients have undergone nephron-sparing surgery for renal cell carcinoma on an elective basis at our institutions. The vast majority of these tumors were incidental findings, with a mean tumor diameter of 3.35 cm (range 0.7 to 5.6). The median follow-up was 8.5 years (range 0.5 to 18), and of those patients alive, 27 (28%) were followed up for more than 10 years.


RESULTS
The pathologic stage was pT1N0M0 in 110 cases (93.2%) and pT3aN0M0 in 8 (6.7%); 59 were grade 1, 52 were grade 2, and 7 were grade 3. Complications occurred in 4 patients, including retroperitoneal bleeding in 1 treated by reoperation, urinomas in 2, and ureteral stricture in 1 treated conservatively. Renal function remained normal during the whole follow-up period, and slight proteinuria was observed in 13 patients. The 10-year distant and local recurrence rate was 4% and 3.9%, respectively. The cancer-specific 5, 10, and 15-year survival rate was 97.3%, 96.4%, and 96.4%, respectively.


CONCLUSIONS
Our experience, based on a long median follow-up, suggests that nephron-sparing surgery on an elective basis can achieve long-term survival for the treatment of incidental and low-stage renal cell carcinomas without compromising the efficacy of cancer treatment.
Delakas
Dimitrios
D
Department of Urology, General University Hospital of Heraklion, Crete, Greece.
Karyotis
Ioannis
I
Daskalopoulos
George
G
Terhorst
Bodo
B
Lymberopoulos
Stavros
S
Cranidis
Angelos
A
D000328:Adult; D000368:Aged; D002292:Carcinoma, Renal Cell / Q000401:mortality / Q000473:pathology* / Q000601:surgery*; D017558:Elective Surgical Procedures; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D033162:Incidental Findings; D007680:Kidney Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery*; D008197:Lymph Node Excision; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000473:pathology; D009367:Neoplasm Staging; D009392:Nephrectomy / Q000379:methods* / Q000401:mortality; D009399:Nephrons; D012189:Retrospective Studies; D015996:Survival Rate