title: Outlining the limits of partial nephrectomy.
abstract: Amongst nephron-sparing modalities, partial nephrectomy (PN) is the standard of care in the treatment of renal cell carcinoma (RCC). Despite the increasing utilization of PN, particularly propagated by robot-assisted, minimally invasive approaches for small renal masses (SRMs), the limits of PN appear to be also evolving. In this review, we sought to address the tumour stage beyond which PN may be oncologically perilous. While the evidence supports PN in the treatment of tumours < pT2a, PN may have a role in advanced or metastatic RCC. Other scenarios wherein PN has limited utility are also explored, including anatomical or surgical factors that dictate the difficulty of the case, such as prior renal surgery. Lastly, we discuss the emerging role of molecular biomarkers, specifically epigenetics, to aid in the risk stratification of SRMs and to select tumours optimally suited for PN.
authors.affiliation: USC Institute of Urology, Catherine & Joseph Aresty Department of Urology, Keck School of Medicine, University of Southern California, Los Angeles, CA 90089, USA.
authors.forename: Sameer
authors.initials: S
authors.lastname: Chopra
authors.affiliation: USC Institute of Urology, Catherine & Joseph Aresty Department of Urology, Keck School of Medicine, University of Southern California, Los Angeles, CA 90089, USA.
authors.forename: Raj
authors.initials: R
authors.lastname: Satkunasivam
authors.affiliation: USC Institute of Urology, Catherine & Joseph Aresty Department of Urology, Keck School of Medicine, University of Southern California, Los Angeles, CA 90089, USA.
authors.forename: Chandan
authors.initials: C
authors.lastname: Kundavaram
authors.affiliation: USC Institute of Urology, Catherine & Joseph Aresty Department of Urology, Keck School of Medicine, University of Southern California, Los Angeles, CA 90089, USA.
authors.forename: Gangning
authors.initials: G
authors.lastname: Liang
authors.affiliation: USC Institute of Urology, Catherine & Joseph Aresty Department of Urology, Keck School of Medicine, University of Southern California, Los Angeles, CA 90089, USA.
authors.forename: Inderbir S
authors.initials: IS
authors.lastname: Gill
keywords: Partial nephrectomy (PN); indications; limits; radical nephrectomy (RN)