title: Is radical nephrectomy a legitimate therapeutic option in patients with renal masses amenable to nephron-sparing surgery?
abstract: The decision to perform a radical nephrectomy (RN) or a partial nephrectomy (PN), not unlike most decisions in clinical practice, ultimately hinges on the balance of risk. Do the higher risks of a more complex surgery (PN) justify the theoretical benefits of kidney tissue preservation? Data suggest that for patients with an anatomically complex renal mass and a normal contralateral kidney, for whom additional surgical intensity may be risky, such as the elderly and comorbid, RN presents a robust treatment option. Nevertheless, PN, especially for small and anatomically simple renal masses in young patients without comorbidities should remain the surgical reference standard, as preservation of renal tissue can serve as an 'insurance policy' not only against future renal functional decline, but also against the possibility of tumour development in the contralateral kidney. In the present review, we outline the ongoing debate between the role of RN and PN in treatment of the enhancing renal mass.
authors.affiliation: Division of Urologic Oncology, Fox Chase Cancer Center-Temple University Health System, Philadelphia, PA, USA.
authors.forename: Jeffrey J
authors.initials: JJ
authors.lastname: Tomaszewski
authors.forename: Marc C
authors.initials: MC
authors.lastname: Smaldone
authors.forename: Robert G
authors.initials: RG
authors.lastname: Uzzo
authors.forename: Alexander
authors.initials: A
authors.lastname: Kutikov
mesh_terms: D006801:Humans; D007680:Kidney Neoplasms / Q000601:surgery*; D009392:Nephrectomy / Q000009:adverse effects / Q000379:methods*; D059351:Organ Sparing Treatments / Q000009:adverse effects / Q000379:methods*; D016032:Randomized Controlled Trials as Topic; D016896:Treatment Outcome
keywords: outcomes; partial nephrectomy; radical nephrectomy