title: [Comparative analysis of conservative surgery versus radical nephrectomy for renal cancer].
abstract: OBJECTIVE
  To compare the results of conservative surgery (CS) and radical nephrectomy (RN) for the treatment of renal cancer.
  
  
  METHODS
  Between 1988 and 1999, more than 900 patients were operated for renal cancer in our department. We compared results of CS (partial nephrectomy and/or lumpectomy) to those of RN on 2 groups of matched patients with a similar sample size (n=62) in terms of morbidity, course of renal function, oncological efficacy and survival.
  
  
  RESULTS
  The mean follow-up was more than 5 years for the two groups. This series comprised a predominance of localized (pT1 and pT2) low-grade (1 and 2) tumours: 80%. In our experience, CS was responsible for greater morbidity than RN, essentially because of indications of necessity compared to elective indications. Although the local recurrence rate was significantly higher after CS, analysis of overall and specific survival did not reveal any significant difference between the two groups.
  
  
  CONCLUSIONS
  Conservative surgery appears to be a reasonable alternative to radical nephrectomy for the treatment of renal cancer in some indications and allows nephron sparing. This option appears to be all the more justified in view of the increasingly frequent discovery of small tumours in increasingly young patients. The development of minimally invasive techniques, particularly laparoscopy, is another aspect of this "minimal" trauma approach, but must be shown to ensure an equivalent oncological efficacy.
authors.affiliation: Service d'Urologie et de Chirurgie de la Transplantation, Hôpital Edouard Herriot, Lyon, France. gilles.pasticier@chu-lyon.fr
authors.forename: Gilles
authors.initials: G
authors.lastname: Pasticier
authors.forename: Lionel
authors.initials: L
authors.lastname: Badet
authors.forename: Marc
authors.initials: M
authors.lastname: Colombel
authors.forename: Sandrine
authors.initials: S
authors.lastname: Touzet
authors.forename: Mohamed
authors.initials: M
authors.lastname: Halila
authors.forename: Hakim
authors.initials: H
authors.lastname: Fassi Fehri
authors.forename: Xavier
authors.initials: X
authors.lastname: Martin
mesh_terms: D000230:Adenocarcinoma / Q000401:mortality / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007680:Kidney Neoplasms / Q000401:mortality / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy; D011183:Postoperative Complications / Q000453:epidemiology; D012189:Retrospective Studies; D015996:Survival Rate