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Adenocarcinoma of the kidney: Nephron-sparing surgical approach vs. radical nephrectomy

✍ Scribed by Barbalias, George A.; Liatsikos, Evangelos N.; Tsintavis, Athanasios; Nikiforidis, George


Publisher
John Wiley and Sons
Year
1999
Tongue
English
Weight
78 KB
Volume
72
Category
Article
ISSN
0022-4790

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✦ Synopsis


Background and Objectives: Radical nephrectomy has been the traditional surgical treatment for renal cell carcinoma in patients with a normally functioning contralateral kidney. The necessity for a less aggressive surgical approach has emerged in cases in which there is a need to preserve renal function. Methods: We retrospectively evaluated the records of 41 patients with localized, symptomless small renal masses (<5 cm) treated with nephronsparing surgery (group A) and 48 patients matched for age, tumor location, size, and stage who were treated with radical nephrectomy (group B).

Results:

The 5-year cancer-specific survival rates were 97.5% and 98.4% for the treated patients of groups A an B, respectively. No statistical association was found between cancer-specific survival and surgical approach, tumor stage, tumor location, or recurrence. The size of the primary tumor did not seem to influence the cause-specific survival. Local recurrence was observed in 3 patients (7.3%) who underwent partial nephrectomy. In our series, the overall incidence of multifocality was 10.4%. Conclusions: We propose segmental renal resection for unifocal small adenocarcinoma of the kidney in preference to radical surgery as it is corroborated by the presented data.