Conservative surgery for renal cell carcinoma: A single-center experience with 100 patients

No AccessJournal of Urology1 Feb 2002Conservative surgery for renal cell carcinoma: A single-center experience with 100 patients Andrew C. Novick, Stevan Streem, James E. Montie, J. Edson Pontes, Steven Siegel, Drogo K. Montague, and Marlene Goormastic Andrew C. NovickAndrew C. Novick More articles by this author , Stevan StreemStevan Streem More articles by this author , James E. MontieJames E. Montie More articles by this author , J. Edson PontesJ. Edson Pontes More articles by this author , Steven SiegelSteven Siegel More articles by this author , Drogo K. MontagueDrogo K. Montague More articles by this author , and Marlene GoormasticMarlene Goormastic More articles by this author View All Author Informationhttps://doi.org/10.1016/S0022-5347(02)80288-9AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail From January 1956 March 1987., 100 patients underwent a conservative (parenchymasparing) operation as curative treatment for renal cell carcinoma at our clinic. This series includes 56 patients with bilateral (28 synchronous and 28 asynchronous) and 44 with unilateral renal cell carcinoma; in the latter category the contralateral kidney was either absent or nonfunctioning (17 patients), functionally impaired (17), involved with a benign disease process (6) or normal (4). The pathological tumor stage was I in 75 patients, II in 9, III in 10 and IV in 6. A nephron-sparing operation was performed in situ in 86 patients and ex vivo in 14. Postoperatively, 93 patients experienced immediate function of the operated kidney, while 7 required dialysis (4 temporary and 3 permanent). The incidence of dialysis was greater after ex vivo than in situ surgery (p equals 0.0005). The mean postoperative serum creatinine level in 97 patients with renal function was 1.7 mg. per dl. (range 0.9 to 4.6 mg. per dl.). The over-all actuarial 5-year patient survival rate in this series is 67 per cent including death of any cause and 84 per cent including only deaths of renal cell carcinoma. Survival was improved in patients with stage I renal cell carcinoma (p less than 0.05). Survival also was improved in patients with unilateral renal cell carcinoma (p less than 0.05) and fewer patients in this category had recurrent disease postoperatively (p less than 0.0005). Nine patients (9 per cent) had local tumor recurrence postoperatively and 5 of these were rendered free of tumor by secondary surgical excision. Conservative surgery provides effective therapy for patients with localized renal cell carcinoma in whom preservation of renal function is a relevant clinical consideration. References 1. : The results of radical nephrectomy for renal cell carcinoma. J. Urol.1969; 101: 297. Link, Google Scholar 2. : Diagnosis and management of renal cell carcinoma: a clinical and pathological study of 309 cases. Cancer1971; 28: 1165. Google Scholar 3. : Treatment of solitary and bilateral renal carcinomas. J. Urol.1979; 121: 581. Link, Google Scholar 4. : Long-term results following partial nephrectomy for localized renal adenocarcinoma. J. Urol.1984; 131: 1050. Link, Google Scholar 5. : Bilateral renal cell carcinoma and renal cell carcinoma in the solitary kidney. J. Urol.1984; 132: 450. Link, Google Scholar 6. : Treatment of renal cell carcinoma by in situ partial nephrectomy and extracorporeal operation with autotransplantation. Mayo Clin. Proc.1985; 60: 651. Crossref, Medline, Google Scholar 7. : Conservative surgery of renal carcinoma: the EIRSS experience. Brit. J. Urol.1981; 53: 528. Google Scholar 8. : Bilateral renal cell carcinoma: influence of synchronous and asynchronous occurrence on patient survival. J. Urol.1982; 128: 913. Link, Google Scholar 9. : Synchronous bilateral renal cell carcinoma: total surgical excision. Cancer1980; 46: 2341. Google Scholar 10. : Conservative surgery of renal cell carcinoma. Eur. Urol.1986; 12: 238. Google Scholar 11. : Partial nephrectomy for renal cell carcinoma. Urol. Clin. N. Amer.1987; 14: 419. Google Scholar 12. : Renal cell carcinoma as an incidental finding. J. Urol.1985; 134: 1094. Link, Google Scholar 13. : Surgical treatment of localized renal cell carcinoma in von Hippel-Lindau's disease. J. Urol.1988; 139: 507. Link, Google Scholar 14. : Surgical enucleation for renal cell carcinoma. J. Urol.1986; 135: 235. Link, Google Scholar 15. : Management of locally recurrent renal cell carcinoma after partial nephrectomy. J. Urol.1987; 138: 607. Link, Google Scholar 16. : Enucleation surgery for renal malignancy. J. Urol.1979; 122: 546. Link, Google Scholar 17. : Conservative surgery for renal cell carcinoma. Eur. Urol.1981; 7: 19. Google Scholar 18. : Value of enucleation, of tumor in solitary kidneys. Eur. Urol.1985; 11: 369. Google Scholar 19. : The feasibility of surgical enucleation for renal cell carcinoma. J. Urol.1986; 135: 231. Link, Google Scholar 20. : Organ-preserving surgery in renal cell carcinoma: tumor enucleation versus partial kidney resection. Eur. Urol.1984; 10: 222. Google Scholar 21. : Urological management of patients with von Hippel-Lindau's disease. J. Urol.1986; 136: 789. Link, Google Scholar © 2002 by American Urological Association, IncFiguresReferencesRelatedDetailsCited byPeycelon M, Hupertan V, Comperat E, Renard-Penna R, Vaessen C, Conort P, Bitker M, Chartier-Kastler E, Richard F and Rouprêt M (2018) Long-Term Outcomes After Nephron Sparing Surgery for Renal Cell Carcinoma Larger Than 4 cmJournal of Urology, VOL. 181, NO. 1, (35-41), Online publication date: 1-Jan-2009.ROUPRET M, HOPIRTEAN V, MEJEAN A, THIOUNN N, DUFOUR B and CHRETIEN Y (2018) Nephron Sparing Surgery for Renal Cell Carcinoma and von Hippel-Lindau’s Disease: A Single Center ExperienceJournal of Urology, VOL. 170, NO. 5, (1752-1755), Online publication date: 1-Nov-2003. Volume 167Issue 2 Part 2February 2002Page: 878-882 Advertisement Copyright & Permissions© 2002 by American Urological Association, IncMetricsAuthor Information Andrew C. Novick More articles by this author Stevan Streem More articles by this author James E. Montie More articles by this author J. Edson Pontes More articles by this author Steven Siegel More articles by this author Drogo K. Montague More articles by this author Marlene Goormastic More articles by this author Expand All Advertisement PDF downloadLoading ...