Enucleation of renal cell carcinoma with ablation of the tumour base.
OBJECTIVE
To retrospectively assess the effectiveness of cancer control with enucleation of renal cell carcinoma (RCC), which is surgically expedient, allows preservation of maximal renal parenchyma, and makes intraoperative renal ischaemia unnecessary, by two surgeons routinely enucleating renal tumours and ablating the tumour bed with argon beam and the Nd-YAG laser.


METHODS
Between 1996 and 2006 at our institution, 97 patients had RCC enucleated, with ablation of the tumour base. Patients with lesions other than RCC and those with von Hippel-Lindau disease or Birt-Hogg-Dube syndrome were excluded from the study. The mean follow-up was 24.9 months. Patients were evaluated for RCC recurrence with cross-sectional imaging at least every 6 months for the first 2 years and then annually thereafter.


RESULTS
The mean (median, range) tumour size was 2.8 (2.5, 0.8-7.0) cm. Of the 97 patients only one had disease progression after a mean follow-up of 24.9 months. This patient presented with a solitary grade 2 clear cell RCC and had a local recurrence 30 months after original surgery.


CONCLUSIONS
The present series and other available clinical data suggest that enucleation with cavity ablation is an oncologically sound approach that is simple, versatile and obviates the need for renal ischaemia.
Kutikov
Alexander
A
Department of Surgery, Division of Urology, Hospital of the University of Pennsylvania, Philadelphia, PA, USA.
Vanarsdalen
Keith N
KN
Gershman
Boris
B
Fossett
Lindsay K
LK
Guzzo
Thomas J
TJ
Wein
Alan J
AJ
Malkowicz
S Bruce
SB
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*; D010535:Laparoscopy; D053685:Laser Therapy / Q000379:methods* / Q000592:standards; D054020:Lasers, Gas / Q000627:therapeutic use; D053844:Lasers, Solid-State / Q000627:therapeutic use; D008297:Male; D009364:Neoplasm Recurrence, Local; D009392:Nephrectomy / Q000379:methods* / Q000592:standards; D012189:Retrospective Studies; D016019:Survival Analysis; D016896:Treatment Outcome