title: Surgical treatment of kidney tumors - contemporary trends in clinical practice.
abstract: BACKGROUND
  The aim of this article is to generally describe the roles of main surgical modalities in treatment of renal tumors, especially in the CT1a category in clinical practice. Surgical modalities include the following: laparoscopic or open resection (LR, OR) and laparoscopic or open nephrectomy (LN, ON). Representation of these methods has been changing over years due to improved operative skills and equipment and due to a shift of tumors to the lower T categories.
  
  
  METHODS
  The sources of data were surgeries performed for renal tumors at the institution of the main author during the period 2002 to III/2016, reaching a total of 2204 cases (546 ONs, 647 LNs, 668 ORs and 343 LRs). Patients indicated for percutaneous ablative therapy or active surveillance were not included.
  
  
  RESULTS
  During the whole period, the proportions of methods were: ONs 24.8%, LNs 29.4%, ORs 30.3%, LRs 15.6%. But during the years 2014 - III/2016, these changed to 12.6%:26.3%:31.6%:29.4% (in cT1a 1.7%:8.3%:37.8%:52.2%). Category cT1a constitutes in the years 2007 - III/2016 41.3%, in 2014 - III/2016 50.9%.
  
  
  CONCLUSIONS
  Resections and minimally invasive approaches are being performed more frequently and are the preferred methods in surgical treatment of kidney tumors. Resection is now indicated in about 60% of cases (openvs.laparoscopic resection are used nearly equally with a slight tendency for laparascopic predomination). In the cT1a category (amounting to approximately 50% of all surgically treated tumors), resection is possible in about 85-90% of cases.
authors.affiliation: University Hospital, Department of Urology, Plzeň, Czech Republic.
authors.forename: Milan
authors.initials: M
authors.lastname: Hora
authors.affiliation: University Hospital, Department of Urology, Plzeň, Czech Republic.
authors.forename: Viktor
authors.initials: V
authors.lastname: Eret
authors.affiliation: University Hospital, Department of Urology, Plzeň, Czech Republic.
authors.forename: Ivan
authors.initials: I
authors.lastname: Trávníček
authors.affiliation: University Hospital, Department of Urology, Plzeň, Czech Republic.
authors.forename: Kristýna
authors.initials: K
authors.lastname: Procházková
authors.affiliation: University Hospital, Department of Urology, Plzeň, Czech Republic.
authors.forename: Tomáš
authors.initials: T
authors.lastname: Pitra
authors.affiliation: University Hospital, Department of Urology, Plzeň, Czech Republic.
authors.forename: Olga
authors.initials: O
authors.lastname: Dolejšová
authors.affiliation: University Hospital, Department of Pathology, Plzeň, Czech Republic.
authors.forename: Ondřej
authors.initials: O
authors.lastname: Hes
authors.affiliation: Department of Pathology, National University Health System, Singapore, Singapore.
authors.forename: Fredrik
authors.initials: F
authors.lastname: Petersson
keywords: histology; incidence; laparoscopy; nephrectomy; renal tumor