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Open partial nephrectomy for the treatment of renal cell carcinoma

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Abstract

Open partial nephrectomy, or nephron-sparing surgery (NSS), is now considered the standard of care for the treatment of small renal tumors. The oncologic efficacy and safety of NSS for the treatment of stage-T1a renal tumors has been repeatedly demonstrated to be equivalent to radical nephrectomy. NSS initially was reserved for patients with solitary kidneys, impaired renal function, hereditary tumor syndromes, bilateral renal tumors, and those with significant comorbidities predisposing to future renal failure. The indications have expanded recently to allow elective partial nephrectomy in the setting of a normal contralateral kidney. Furthermore, recent data demonstrate that partial nephrectomy for larger tumors (T1b), which have been historically treated with radical nephrectomy, is a viable option when surgical margins can safely be achieved. In the era of minimally invasive techniques, laparoscopic NSS is technically feasible, yet long-term studies are still needed to assess oncologic efficacy. New NSS ablative technologies, such as cryoablation and radiofrequency ablation, are on the horizon. In this article, we discuss the role of open NSS and surgical technique in the contemporary management of renal tumors.

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Authors and Affiliations

  1. Department of Urology, David Geffen School of Medicine at UCLA, 10833 Le Conte Avenue, 66-118 CHS, Box 951738, 90095-1738, Los Angeles, CA, USA

    Arie S. Belldegrun MD

Authors
  1. Brian Shuch MD
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  2. John S. Lam MD
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  3. Arie S. Belldegrun MD
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Correspondence to Arie S. Belldegrun MD.

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Shuch, B., Lam, J.S. & Belldegrun, A.S. Open partial nephrectomy for the treatment of renal cell carcinoma. Curr Urol Rep 7, 31–38 (2006). https://doi.org/10.1007/s11934-006-0035-8

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  • DOI: https://doi.org/10.1007/s11934-006-0035-8

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