Adenocarcinoma of the kidney: nephron-sparing surgical approach vs. radical nephrectomy

J Surg Oncol. 1999 Nov;72(3):156-61. doi: 10.1002/(sici)1096-9098(199911)72:3<156::aid-jso8>;2-t.


Background and objectives: Radical nephrectomy has been the traditional surgical treatment for renal cell carcinoma in patients with a normally functioning contralateral kidney. The necessity for a less aggressive surgical approach has emerged in cases in which there is a need to preserve renal function.

Methods: We retrospectively evaluated the records of 41 patients with localized, symptomless small renal masses (<5 cm) treated with nephron-sparing surgery (group A) and 48 patients matched for age, tumor location, size, and stage who were treated with radical nephrectomy (group B).

Results: The 5-year cancer-specific survival rates were 97.5% and 98. 4% for the treated patients of groups A an B, respectively. No statistical association was found between cancer-specific survival and surgical approach, tumor stage, tumor location, or recurrence. The size of the primary tumor did not seem to influence the cause-specific survival. Local recurrence was observed in 3 patients (7.3%) who underwent partial nephrectomy. In our series, the overall incidence of multifocality was 10.4%.

Conclusions: We propose segmental renal resection for unifocal small adenocarcinoma of the kidney in preference to radical surgery as it is corroborated by the presented data.

Publication types

  • Comparative Study

MeSH terms

  • Adenocarcinoma / mortality
  • Adenocarcinoma / pathology
  • Adenocarcinoma / surgery*
  • Adult
  • Aged
  • Humans
  • Kidney Neoplasms / mortality
  • Kidney Neoplasms / pathology
  • Kidney Neoplasms / surgery*
  • Middle Aged
  • Nephrectomy*
  • Nephrons / surgery*
  • Retrospective Studies
  • Survival Rate