Elective nephron sparing surgery by tumor enucleation for small (≤ 5 cm) renal cell carcinoma

Marco Grasso, Luigi F. Da Pozzo, Vincenzo Scattoni, Caterina Lania, Lisa Pennacchioli, Francesco Francesca, Massimo Freschi, Patrizio Rigatti

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Abstract

INTRODUCTION AND OBJECTIVES: Elective nephron sparing surgery in patients with low stage renal cell carcinoma and a normal controlateral kidney, is an intriguing but yet to be established alternative to radical nephrectomy. It remains a matter of controversial debate the maximum tumor size, the surgical approach and the surgical technique required for this procedure. In this study we have considered the clinical outcome of a group of patients submitted to elective tumor enucleation for small (≤ 5 cm) renal cell carcinoma. METHODS: 36 patients (mean age 59.6 years) with a small (≤ 5 cm) solitary renal cancer and a normal controlateral kidney were submitted to tumor enucleation through a transperitoneal approach. Frozen step sections of surgical margins were examined intraoperatively. The mean follow-up time is 38 months. RESULTS: Bleeding could be controlled without clamping the renal artery in 22 cases, while renal ischemia was necessary in the remaining 14 cases (mean ischemia time: 16 minutes). The mean surgical bleeding was 420 cc. Frozen sections of the surgical margins were negative in all cases. Renal function remained normal in all cases. One patient, with a tumor size of 4.6 cm at the time of nephron sparing surgery, experienced local recurrence 12 months postoperatively and underwent radical nephrectomy. All patients are alive and cancer free. CONCLUSIONS: Elective tumor enucleation for small (≤ 5 cm) renal cell carcinoma can be conducted safely and with low risk of local recurrence. Longer follow-up and randomized series versus standard radical nephrectomy and other techniques for nephron sparing surgery are required before this procedure can be more widely recommended in clinical practice.

Original languageEnglish
Pages (from-to)141
Number of pages1
JournalBritish Journal of Urology
Volume80
Issue numberSUPPL. 2
Publication statusPublished - 1997

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ASJC Scopus subject areas

  • Urology

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Grasso, M., Da Pozzo, L. F., Scattoni, V., Lania, C., Pennacchioli, L., Francesca, F., Freschi, M., & Rigatti, P. (1997). Elective nephron sparing surgery by tumor enucleation for small (≤ 5 cm) renal cell carcinoma. British Journal of Urology, 80(SUPPL. 2), 141.