Localized renal cell carcinoma management: an update.
OBJECTIVE
To review the current modalities of treatment for localized renal cell carcinoma.


METHODS
A literature search for keywords: renal cell carcinoma, radical nephrectomy, nephron sparing surgery, minimally invasive surgery, and cryoablation was performed for the years 2000 through 2008. The most relevant publications were examined.


RESULTS
New epidemiologic data and current treatment of renal cancer were covered. Concerning the treatment of clinically localized disease, the literature supports the standardization of partial nephrectomy and laparoscopic approaches as therapeutic options with better functional results and oncologic success comparable to standard radical resection. Promising initial results are now available for minimally invasive therapies, such as cryotherapy and radiofrequency ablation. Active surveillance has been reported with acceptable results, including for those who are poor surgical candidates.


CONCLUSIONS
This review covers current advances in radical and conservative treatments of localized kidney cancer. The current status of nephron-sparing surgery, ablative therapies, and active surveillance based on natural history has resulted in great progress in the management of localized renal cell carcinoma.
Heldwein
Flavio L
FL
Department of Urology, Institute Montsouris, Paris, France. flavio.lobo@gmail.com
McCullough
T Casey
TC
Souto
Carlos A V
CA
Galiano
Marc
M
Barret
Eric
E
D002292:Carcinoma, Renal Cell / Q000473:pathology / Q000601:surgery*; D017115:Catheter Ablation; D003452:Cryosurgery; D006801:Humans; D007680:Kidney Neoplasms / Q000473:pathology / Q000601:surgery*; D010535:Laparoscopy; D020360:Neoadjuvant Therapy; D009392:Nephrectomy / Q000379:methods; D016634:Radiosurgery