title: Surgical resection for locally invasive renal cell carcinoma: Is it worthwhile?
abstract: BACKGROUND
  Many patients with renal cell carcinoma (RCC) present with disease involving the adjacent viscera. Although survival in such patients is poor, surgery remains the only proven modality of treatment. We describe our experience with radical nephrectomy for locally invasive RCC over a five-year period.
  
  
  METHODS
  A retrospective analysis of the records of all patients who had undergone surgery for locally invasive RCC between January 1999 and December 2004 at our institute.
  
  
  METHODS
  During the study period, 102 patients with RCC underwent surgery at our institute, out of which 18 (17.6%) patients had adjacent organ involvement. The survival and outcomes in terms of symptom relief are described.
  
  
  METHODS
  The survival rates were calculated by the Kaplan-Meier method using EGRET statistical software package.
  
  
  RESULTS
  Of the 18 patients, two patients had inoperable disease. Fifteen out of the 18 patients succumbed to their disease after a median period of 7.5 months. Three patients are still alive, having survived for 13, 16 and 25 months. Most patients derived considerable benefit with respect to relief of symptoms, which was long-lasting.
  
  
  CONCLUSIONS
  For selected patients with locally invasive RCC, radical nephrectomy with en bloc resection of involved organs may provide the opportunity for long-term survival. In others, it may provide considerable symptomatic relief.
authors.affiliation: Department of Surgical Oncology, Kidwai Memorial Institute of Oncology, Karnataka, India.
authors.forename: Suraj
authors.initials: S
authors.lastname: Manjunath
authors.forename: C
authors.initials: C
authors.lastname: Ramachandra
authors.forename: Vijayashree
authors.initials: V
authors.lastname: Murthy
authors.forename: Prashanth S
authors.initials: PS
authors.lastname: Murthy
authors.forename: P S
authors.initials: PS
authors.lastname: Prabhakaran
authors.forename: V Satya Suresh
authors.initials: VS
authors.lastname: Attili