[Nephron-sparing surgery for small renal cell carcinoma: clinical analysis of 21 cases].
OBJECTIVE
To evaluate the clinical effects of nephron-sparing surgery in patients with early-stage small renal cell carcinoma.


METHODS
Nephron-sparing surgery was performed in 21 patients with renal cell carcinoma including 1 with solitary kidney, 3 with unilateral tumor and contralateral renal compromise, and 17 with unilateral tumor and normal contralateral kidney. The diameter of the tumors ranged from 1.5 to 6.0 cm, with a mean of 2.8 cm. The tumor diameter in 17 patients with normal contralateral kidney was less than 4 cm (mean 2.5 cm) and the average diameter in 4 patients with contralateral renal compromise was 4.2 cm. Sixteen cases were in stage T(1), 4 in stage T(2), and 1 in stage T(3). Of the 21 patients, 4 underwent tumor enucleation, 10 polar nephrectomy and 7 wedge resection.


RESULTS
All patients were followed up for an average of 40.8 months (7 to 66 months). One patient suffered a right lung and mediastinum metastasis 3 years after the surgery later and 1 with chronic glomerulonephritis required dialysis 27 months after the operation. No surgical complication or local recurrence were found in other patients.


CONCLUSIONS
As a safe and effective therapy for early-stage small renal cell carcinoma, nephron-sparing surgery can be considered as the gold-standard therapy for patients with lesions less than 4 cm in T(1) and T(2) stages of localized unilateral tumor with normal contralateral kidney.
Xiao
Yao-Jun
YJ
Department of Urology, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China. xyj@9882002@sina.com
Zheng
Shao-Bin
SB
Tan
Wan-Long
WL
Chen
Tong
T
Qi
Huan
H
Shao
Zhi-Qiang
ZQ
Jiang
Yao-Dong
YD
Wu
Peng
P
Zhang
Hui-Jian
HJ
D000328:Adult; D000368:Aged; D002292:Carcinoma, Renal Cell / Q000473:pathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007680:Kidney Neoplasms / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy / Q000379:methods*; D011379:Prognosis