Nephron-Sparing Surgery Strategy: The Current Standard for the Treatment of Localised Renal Cell Carcinoma
2011 (English)In: European urology. Supplement, ISSN 1569-9056, E-ISSN 1878-1500, Vol. 10, no 3, E49-E51 p.Article in journal (Refereed) Published
Context: In the past few years, there has been a trend towards nephron-sparing surgery (NSS) strategies in renal cell carcinoma (RCC). The previous standard treatment-radical nephrectomy (RN)-has been abandoned, because a number of studies have shown similar oncologic outcomes after NSS for localised RCCs at least up to 7 cm. RN is recommended only in patients with locally advanced tumour growth; those who have an unfavourable tumour location; or for other clinical reasons, such as general health. Objective: The major advantage of NSS is the preservation of renal function. Evidence acquisition: Medical literature was retrieved from PubMed. Evidence synthesis: Already, one-fourth of patients in the current RCC population having tumours <4 cm in size have significantly impaired renal function diagnostic for stage 3 chronic kidney disease. Patients who have and those at risk for impaired renal function of the contralateral kidney have a higher risk for cardiovascular events and decreased overall mortality after RN. Conclusions: In general, NSS is currently advocated for patients with pT1 RCCs whenever technically feasible. This recommendation is based on the evidence that preserving kidney function in the long term results in reduced frequency of cardiovascular events and decreased overall mortality than after RN. Compared with RN, NSS has slightly higher complication rates but is a safe technique offering similar oncologic results. (C) 2011 European Association of Urology. Published by Elsevier B.V. All rights reserved.
Place, publisher, year, edition, pages
2011. Vol. 10, no 3, E49-E51 p.
Renal cell carcinoma, Renal function, Nephron-sparing surgery, Partial nephrectomy, Comorbidity
Urology and Nephrology
IdentifiersURN: urn:nbn:se:umu:diva-104873DOI: 10.1016/j.eursup.2011.03.003ISI: 000290726700010OAI: oai:DiVA.org:umu-104873DiVA: diva2:821280