[What is the importance of kidney cancer surgery in contrast with targeted therapies?].
Despite the extraordinary development of the medical treatment of kidney cancer, its treatment remains very surgical in localized and metastatic stage. Advances in surgery have accompanied the advent of targeted therapies. The laparoscopy has become the reference procedure for radical nephrectomy in the case of T1-T2 tumors. Partial nephrectomy, currently widespread, should be the first surgical procedure to consider in cases of tumors less than 4 cm. Partial nephrectomy for tumors between 4 and 7 cm is feasible for selected patients with favorable tumor localization. In the future, the use of neo-adjuvant anti-angiogenesis agents could broaden the scope of partial nephrectomy. Laparoscopic partial nephrectomy is spreading but is still considered as a therapeutic option, conducted in reference centres. In case of metastatic disease, pending the results of randomized trials including patients on anti-angiogenesis agents, cytoreductive nephrectomy remains indicated for patients in good general condition with kidney cancer metastatic immediately.
Ploussard
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CHU Henri-Mondor, AP-HP, Service d'urologie, Inserm U955 Eq07, Université Paris-XII-Val-de-Marne, 51, avenue du Maréchal-de-Lattre-de-Tassigny, Créteil, France.
de La Taille
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D020533:Angiogenesis Inhibitors / Q000627:therapeutic use; D003131:Combined Modality Therapy; D006801:Humans; D007680:Kidney Neoplasms / Q000188:drug therapy / Q000601:surgery*; D010535:Laparoscopy / Q000379:methods*; D009392:Nephrectomy / Q000379:methods*
D020533:Angiogenesis Inhibitors