Skip to main content

Advertisement

SpringerLink
Log in

Imperative organerhaltende Nierentumorchirugie bei Einzelniere bzw. bilateralen Tumoren

Langzeitergebnisse

Imperative nephron-sparing surgery for cases of solitary kidney/bilateral tumors

Long-term results

  • Leitthema
  • Published:
Der Urologe Aims and scope Submit manuscript

Zusammenfassung

Das Nierenzellkarzinom ist das Malignom mit der höchsten Letalität unter den urologischen Tumoren. Nur durch eine chirurgische Entfernung des Tumors besteht für Patienten mit lokal begrenzten Nierentumoren die Chance der kurativen Therapie. Einen besonderen Stellenwert besitzt die organerhaltende Nierentumorchirurgie bei Patienten mit Tumoren in beiden Nieren oder in einer Einzelniere. Für diese Patienten ist der Erhalt der Nierenfunktion essentiell (imperative Indikation).

Bei der Evaluation der Patienten mit Tumoren in einer Einzelniere oder in beiden Nieren muss das chirurgische und onkologische Risiko eines organerhaltenden nierentumorchirurgischen Eingriffs gegenüber der Morbidität eines radikalchirurgischen Vorgehens mit nachfolgender Dialyse und einer möglichen späteren Transplantation abgewogen werden. Im vorliegenden Beitrag berichten wir über unsere onkologischen und funktionellen Langzeitergebnisse der organerhaltenden Nierentumorchirurgie bei Patienten mit imperativer Indikationsstellung.

Abstract

Renal cell carcinoma is the most lethal amongst urological malignancies. Only surgical excision of the tumor offers the chance of curative therapy for patients with localized disease. Nephron-sparing surgery is mandatory for patients with renal tumors in both kidneys or in a solitary kidney in order to preserve renal function (imperative indication).

Evaluation of patients with renal tumors in both kidneys or in a solitary kidney must weigh the surgical and oncological risks of nephron-sparing surgery against the morbidity of radical nephrectomy followed by hemodialysis and possibly renal transplantation. Herein we report our oncological and functional long-term results of nephron-sparing surgery in patients with an imperative indication and review the literature.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Abb. 1
Abb. 2
Abb. 3

Literatur

  1. Bazeed MA, Scharfe T, Becht E et al. (1986) Conservative surgery of renal cell carcinoma. Eur Urol 12: 238–243

    PubMed  CAS  Google Scholar 

  2. Belldegrun A, Tsui KH, de Kernion JB et al. (1999) Efficacy of nephron-sparing surgery for renal cell carcinoma: analysis based on the new 1997 tumor-nodemetastasis staging system. J Clin Oncol 17: 2868–2875

    PubMed  CAS  Google Scholar 

  3. Blute ML, Itano NB, Cheville JC et al. (2003) The effect of bilaterality, pathological features and surgical outcome in nonhereditary renal cell carcinoma. J Urol 169: 1276–1281

    Article  PubMed  Google Scholar 

  4. Robert Koch-Institut und die Gesellschaft der epidemiologischen Krebsregister in Deutschland e.V. (Hrsg)(2008) Krebs in Deutschland 2003–2004. Häufigkeiten und Trends, 6. überarbeitete Aufl. RKI, Berlin

  5. Fergany AF, Saad IR, Woo L, Novick AC (2006) Open partial nephrectomy for tumor in a solitary kidney: experience with 400 cases. J Urol 175: 1630–1633

    Article  PubMed  Google Scholar 

  6. Ficarra V, Novara G, Galfano A et al. (2004) Application of TNM, 2002 version, in localized renal cell carcinoma: is it able to predict different cancer-specific survival probability? Urology 63: 1050–1054

    Article  PubMed  Google Scholar 

  7. Frank I, Blute ML, Cheville JC et al. (2003) Solid renal tumors: an analysis of pathological features related to tumor size. J Urol 170: 2217–2220

    Article  PubMed  Google Scholar 

  8. Hafez KS, Fergany AF, Novick AC (1999) Nephron sparing surgery for localized renal cell carcinoma: impact of tumor size on patient survival, tumor recurrence and TNM staging. J Urol 162: 1930–1933

    Article  PubMed  CAS  Google Scholar 

  9. Ghavamian R, Cheville JC, Lohse CM et al. (2002) Renal cell carcinoma in the solitary kidney: an analysis of complications and outcome after nephron sparing surgery. J Urol 168: 454–459

    Article  PubMed  Google Scholar 

  10. Grimaldi G, Reuter V, Russo P (1998) Bilateral non-familial renal cell carcinoma. Ann Surg Oncol 5: 548–552

    Article  PubMed  CAS  Google Scholar 

  11. Jemal A, Murray T, Ward E et al. (2005) Cancer Statistics, CA Cancer J Clin 55: 10–30

  12. Lam JS, Shvarts O, Leppert JT et al. (2005): Renal cell carcinoma new frontiers in staging, prognostication and targeted molecular therapy. J Urol 173: 1853–1862

    Article  PubMed  Google Scholar 

  13. Lane BR, Novick AC (2007) Nephron-sparing surgery. BJU Int 99: 1245–1250

    Article  PubMed  Google Scholar 

  14. Leibovich BC, Blute ML, Cheville JC et al. (2004) Nephron sparing surgery for appropriately selected renal cell carcinoma between 4 and 7 cm results in outcome similar to radical nephrectomy. J Urol 171: 1066–1070

    Article  PubMed  Google Scholar 

  15. Mathew A, Devesa SS, Fraumeni JF et al. (2002) Global increases in kidney cancer incidence, 1973–92. Eur J Cancer Prev 11: 171–178

    Article  PubMed  CAS  Google Scholar 

  16. Pahernik S, Gillitzer R, Thuroff JW (2004) Surgical atlas. Cone/wedge resection of renal cell carcinoma. BJU Int 93: 639–654

    Article  PubMed  CAS  Google Scholar 

  17. Pahernik S, Roos F, Wiesner C, Thüroff JW et al. (2007) Nephron sparing surgery for renal cell carcinoma in a solitary kidney. World J Urol 25: 513–517

    Article  PubMed  Google Scholar 

  18. Pahernik S, Cudovic D, Roos F et al. (2007) Bilateral synchronous sporadic renal cell carcinoma: surgical management, oncological and functional outcomes. BJU Int 100: 26–29

    Article  PubMed  Google Scholar 

  19. Pantuck AJ, Zisman A, Belldegrun AS (2001) The changing natural history of renal cell carcinoma. J Urol 166: 1611–1623

    Article  PubMed  CAS  Google Scholar 

  20. Parkin DM, Bray F, Ferlay J, Pisani P (2005) Global cancer statistics, CA Cancer J Clin 55: 74–108

    Google Scholar 

  21. Patard JJ, Shvarts O, Lam JS et al. (2004) Safety and efficacy of partial nephrectomy for all T1 tumors based on an international multicenter experience. J Urol 171: 2181–2185

    Article  PubMed  Google Scholar 

  22. Perez-Farinos N, Lopez-Abente G, Pastor-Barriuso R (2006) Time trend and age-period-cohort effect on kidney cancer mortality in Europe, 1981–2000. BMC Public Health 6: 119

    Article  PubMed  Google Scholar 

  23. Permpongkosol S et al. (2006) Positive surgical parenchymal margin after laparoscopic partial nephrectomy for renal cell carcinoma: oncological outcomes. J Urol 176: 2401–2404

    Article  PubMed  Google Scholar 

  24. Robson CJ, Churchill BM, Anderson W (1969) The results of radical nephrectomy for renal cell carcinoma. J Urol 101: 297–301

    PubMed  CAS  Google Scholar 

  25. Saranchuk JW, Touijer AK, Hakimian P et al. (2002) Partial nephrectomy for patients with a solitary kidney: the Memorial Sloan-Kettering experience. BJU Int 94: 1323–1328

    Article  Google Scholar 

  26. Siemer S, Uder M, Zell A et al. (2001) Bilateral kidney tumor: Therapy management and histopathological results with long-term follow-up of 66 patients. Urologe A 40: 114–120

    Article  PubMed  CAS  Google Scholar 

  27. Thompson RH, Frank I, Lohse CM, et al. (2007) The impact of ischemia time during open nephron sparing surgery on solitary kidneys: a multi-institutional study. J Urol 177: 471–476

    Article  PubMed  Google Scholar 

  28. Uzzo RG, Novick AC (2001) Nephron sparing surgery for renal tumors: indications, techniques and outcomes. J Urol 166: 6–18

    Article  PubMed  CAS  Google Scholar 

  29. Vermooten V (1950) Indications for conservative surgery in certain renal tumors: a study based on the growth patterns of clear cell carcinoma. J Urol 64: 200–208

    PubMed  CAS  Google Scholar 

  30. Wells S (1888) Successful removal of two solid circumrenal tumours. Br Med J 41: 758

    Google Scholar 

Download references

Interessenkonflikt

Der korrespondierende Autor gibt an, dass kein Interessenkonflikt besteht.

Author information

Authors and Affiliations

  1. Klinik und Poliklinik für Urologie, Johannes-Gutenberg-Universität, Langenbeckstraße 1, 55101, Mainz, Deutschland

    F.C. Roos, S. Pahernik, W. Brenner & J.W. Thüroff

  2. Institut für Medizinische Biometrie, Epidemiologie and Informatik, Johannes-Gutenberg-Universität, Mainz, Deutschland

    A. Elsäßer & A. Victor

Authors
  1. F.C. Roos
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. S. Pahernik
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. A. Elsäßer
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. A. Victor
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. W. Brenner
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. J.W. Thüroff
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to F.C. Roos.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Roos, F., Pahernik, S., Elsäßer, A. et al. Imperative organerhaltende Nierentumorchirugie bei Einzelniere bzw. bilateralen Tumoren. Urologe 47, 818–823 (2008). https://doi.org/10.1007/s00120-008-1712-7

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00120-008-1712-7

Schlüsselwörter

Keywords

Search

Navigation