Review of the current status of tumor enucleation for renal cell carcinoma.
Tumor enucleation consists of excising the tumor by blunt dissection following the natural cleavage plane between the peritumoral pseudocapsule and the renal parenchyma without removing a visible rim of healthy renal tissue. In the very recent years, the urological current opinion have changed from a wide skepticism against tumor enucleation to a wider level of acceptance based on the lack of correlation between the width of the resection margin and the risk of disease progression/local recurrence and on larger retrospective series on tumor enucleation with longer follow up. The aim of the present review is to report the technique of tumor enucleation, discuss some technical aspects that can vary between centers and to summarize the oncological and surgical results of this technique for the conservative treatment of RCC in the last 10 years; finally, to briefly present the pathological findings on pseudocapsule and surgical margins prospectively evaluated after tumor enucleation.
Minervini
Andrea
A
Department of Urology, University of Florence, Careggi Hospital, Florence, Italy. andreamine@libero.it
Tuccio
Agostino
A
Lapini
Alberto
A
Lanzi
Federico
F
Vittori
Gianni
G
Siena
Giampaolo
G
Tosi
Nicola
N
Serni
Sergio
S
Carini
Marco
M
D002292:Carcinoma, Renal Cell / Q000473:pathology / Q000601:surgery*; D018450:Disease Progression; D005500:Follow-Up Studies; D006801:Humans; D007680:Kidney Neoplasms / Q000473:pathology / Q000601:surgery*; D009364:Neoplasm Recurrence, Local / Q000517:prevention & control*; D009367:Neoplasm Staging; D009392:Nephrectomy / Q000379:methods*; D016896:Treatment Outcome