Current status of open partial nephrectomy.
OBJECTIVE
To assess the current status of open partial nephrectomy (OPN) for the treatment of renal tumors.


RESULTS
Today, the standard indications for open nephron-sparing surgery are renal tumors in solitary kidneys, bilateral renal masses, tumors in patients with impaired renal function and unilateral masses smaller than 4 cm in diameter with a normal functioning contralateral kidney. For the latter, OPN is increasingly being challenged by laparoscopic partial nephrectomy, which in the hands of experts appears to achieve comparable oncological results, although at a higher complication rate. In selected situations, OPN appears justified in intermediate-risk patients with tumors up to 7 cm in diameter. Long-term outcome data indicate that OPN has cancer-free survival rates comparable to those of radical surgery with better preservation of renal function, decreased overall mortality and reduced frequency of cardiovascular events.


CONCLUSIONS
OPN remains the standard of care for small renal masses and is increasingly advocated in selected patients with tumors up to 7 cm in diameter.
Margreiter
Markus
M
Department of Urology, Medical University of Vienna, Vienna, Austria. markus.margreiter@meduniwien.ac.at
Marberger
Michael
M
D018572:Disease-Free Survival; D006801:Humans; D007680:Kidney Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D010535:Laparoscopy / Q000009:adverse effects; D009367:Neoplasm Staging; D009392:Nephrectomy / Q000009:adverse effects / Q000379:methods*; D018579:Patient Selection; D018570:Risk Assessment; D013997:Time Factors; D016896:Treatment Outcome