title: [Kidney function and renal cancer surgery].
abstract: Although radical nephrectomy is still practiced in many patients with large renal tumors, oncology and nephrology arguments for kidney-sparing approach for small renal masses has taken over this first. Indeed, partial nephrectomy provides equivalent oncologic results while preserving renal function and thereby limit morbidity and cardiovascular mortality related to chronic kidney disease. In addition, patients who develop kidney cancer often have medical comorbidities that may affect renal function, such as diabetes and hypertension. Histological examination of renal tissue adjacent to the tumor showed significant pathological changes in the majority of patients. For elderly patients or patients with comorbidities, active surveillance allows kidney-sparing approach with extremely low rates of progression and metastasis of cancer disease. Despite these significant advances in understanding for the treatment of small renal masses, partial nephrectomy remains underused. Better management must take into account the preservation of renal function in order to increase overall survival. A strategy for the systematic evaluation of renal function in patients with CR, with multidisciplinary staff (nephrologist urologist and oncologist), is therefore highly desirable.
authors.affiliation: Hôpital de la Pitié-Salpêtrière, service de néphrologie, 43-87, boulevard de l'Hôpital, Paris, France.
authors.forename: Hassan
authors.initials: H
authors.lastname: Izzedine
authors.affiliation: Hôpital Européen Georges Pompidou, service d'urologie, 20, rue Leblanc, 75908 Paris cedex 15, France.
authors.forename: Arnaud
authors.initials: A
authors.lastname: Méjean
authors.affiliation: Institut Gustave Roussy, service d'oncologie médicale, 114, rue Édouard-Vaillant, 94805 Villejuif cedex, France.
authors.forename: Bernard
authors.initials: B
authors.lastname: Escudier
mesh_terms: D002292:Carcinoma, Renal Cell / Q000473:pathology / Q000601:surgery*; D002318:Cardiovascular Diseases / Q000401:mortality; D005260:Female; D006801:Humans; D007668:Kidney / Q000473:pathology / Q000503:physiopathology*; D007680:Kidney Neoplasms / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging / Q000379:methods; D009392:Nephrectomy / Q000009:adverse effects / Q000379:methods*; D059351:Organ Sparing Treatments / Q000009:adverse effects / Q000379:methods*; D051436:Renal Insufficiency, Chronic / Q000209:etiology; D012307:Risk Factors; D047368:Tumor Burden
keywords: cardiovascular risk; partial nephrectomy; radical nephrectomy; renal cancer; renal function
vernacular_title: Fonction rénale et chirurgie du cancer du rein.