title: Update on contemporary management of clinically localized renal cell carcinoma.
abstract: Renal cell carcinoma (RCC) continues to increase in incidence with the largest increase manifesting in small, organ-confined tumors. This review outlines the epidemiology and current data pertaining to the management of clinically-localized RCC. In this manuscript, the current data outlining the benefit of nephron sparing to the overall survival of the patient is described. The data pertaining to minimally invasive nephron sparing is also explained in detail. From laparoscopic and robotic partial nephrectomy to watchful waiting and percutaneous ablation, the urologist is continually assaulted with new data for the management of clinically-localized RCC. The data can be confusing, and much of it is conflicting. The addition of new scoring systems or nomograms may aid in predicting which therapy would be most beneficial in certain patient groups. New scoring systems may also predict the difficulty of surgical resection and predict surgical complications. The limitations of the data pertaining to the management of clinically-localized RCC are also outlined.
authors.affiliation: Department of Urology, Mayo Clinic, Jacksonville, FL 32224, USA.
authors.forename: J J
authors.initials: JJ
authors.lastname: Jorns
authors.forename: D D
authors.initials: DD
authors.lastname: Thiel
authors.forename: E P
authors.initials: EP
authors.lastname: Castle
mesh_terms: D001706:Biopsy; D002292:Carcinoma, Renal Cell / Q000453:epidemiology / Q000473:pathology / Q000601:surgery*; D017115:Catheter Ablation; D015331:Cohort Studies; D003452:Cryosurgery / Q000379:methods; D019468:Disease Management; D057086:High-Intensity Focused Ultrasound Ablation; D006801:Humans; D015994:Incidence; D007431:Intraoperative Complications / Q000209:etiology / Q000517:prevention & control; D007668:Kidney / Q000098:blood supply; D007680:Kidney Neoplasms / Q000453:epidemiology / Q000473:pathology / Q000601:surgery*; D010535:Laparoscopy / Q000379:methods; D019060:Minimally Invasive Surgical Procedures; D009367:Neoplasm Staging; D009392:Nephrectomy / Q000379:methods*; D049451:Nomograms; D059351:Organ Sparing Treatments; D012371:Robotics; D016896:Treatment Outcome; D047368:Tumor Burden; D052096:Warm Ischemia; D057832:Watchful Waiting