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Partial nephrectomy: the rationale for expanding the indications.

Paul Russo·Manlio Goetzl·Rachel Simmons·Jared Katz·Robert Motzer·Victor Reuter
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Abstract

BACKGROUND: We report preliminary results of partial nephrectomy for renal tumors of > or =4 cm in 39 patients with the intent of extending the indications for kidney-sparing surgery. METHODS: From July 1989 to October 2001, 39 patients underwent a partial nephrectomy for renal cortical tumors >4 cm in maximum diameter. Fourteen (36%) had the procedure performed for essential reasons, and 25 (64%) had an elective kidney-sparing operation. We evaluated tumor location and histology, perioperative renal function, and postoperative complications. RESULTS: There were 20 conventional clear-cell (51%), 13 papillary (33%), 4 chromophobe (10%), and 3 oncocytomas (8%) with a median tumor size of 5 cm. After a median follow-up of 13 months, 36 patients had no evidence of disease, 1 patient had died as a result of other causes, and 2 patients who had essential operations were alive with disease. Twenty-three patients (70%) maintained normal postoperative renal function. Of six patients with moderate preoperative renal dysfunction, five (83%) had no change in postoperative renal function and only one patient required short-term dialysis. CONCLUSIONS: With careful patient selection, partial nephrectomy can be effectively used to treat patients with renal cortical tumors >4 cm in diameter. The benefits of this approach include the effective local tumor control while at the same time preserving maximum renal function.

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AdultAgedAged, 80 and overDisease-Free SurvivalFemaleHumansKidney NeoplasmsMaleMiddle AgedNeoplasm StagingNephrectomyNew York CityPatient SelectionSurvival RateJournal Article

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Paul Russo, Manlio Goetzl, Rachel Simmons, Jared Katz, Robert Motzer, Victor Reuter. 2002. Partial nephrectomy: the rationale for expanding the indications.. https://doi.org/10.1007/bf02574485

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