The medical and oncological rationale for partial nephrectomy for the treatment of T1 renal cortical tumors.
This article presents the oncological and medical rationale for partial nephrectomy as the treatment of choice whenever possible for T1 renal tumors. The value of partial nephrectomy in the management of small renal cortical tumors is gaining wider recognition thanks to (1) enhanced understanding of the biology of renal cortical tumors; (2) better knowledge about tumor size and stage migration to small tumors at the time of presentation; (3) studies indicating the oncologic efficacy of kidney-sparing surgery, and (4) increasing awareness of the wide prevalence of chronic kidney disease. The overzealous use of radical nephrectomy for small renal tumors must now be considered detrimental to the long-term health and safety of the patient with a small renal cortical tumor.
Russo
Paul
P
Department of Surgery, Urology Service, Weill Cornell College of Medicine, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY 10021, USA. russop@MSKCC.org
Huang
William
W
D002292:Carcinoma, Renal Cell / Q000601:surgery*; D018572:Disease-Free Survival; D019317:Evidence-Based Medicine; D006801:Humans; D007672:Kidney Cortex / Q000473:pathology* / Q000601:surgery*; D007677:Kidney Function Tests; D007680:Kidney Neoplasms / Q000601:surgery*; D009392:Nephrectomy / Q000009:adverse effects / Q000379:methods* / Q000706:statistics & numerical data; D051436:Renal Insufficiency, Chronic / Q000175:diagnosis / Q000209:etiology; D018570:Risk Assessment; D012307:Risk Factors