Functional preservation in patients with renal cortical tumors: The rationale for partial nephrectomy Journal Article


Author: Russo, P.
Article Title: Functional preservation in patients with renal cortical tumors: The rationale for partial nephrectomy
Abstract: Renal cortical tumors (RCT) are a family of neoplasms with diverse histology and metastatic potentials. Conventional clear cell tumors account for 54% of all RCT and 90% of those that metastasize. Liberal use of abdominal imaging detects 70% of RCT incidentally and at a small size (< 4 cm in diameter). Emerging evidence strongly favors partial nephrectomy (PN) as the primary treatment when technically possible for tumors 7 cm or smaller. This approach provides local tumor control equivalent to radical nephrectomy (RN) and prevents or delays chronic kidney disease (CKD) onset. CKD is present in 26% of apparently well patients with such small renal tumors and is an independent risk factor for cardiovascular disease, hospitalization, and death. The likelihood of freedom from an estimated glomerular filtration rate lower than 45 mL/min/1.73m2, a level of significant CKD, is 95% after PN, but only 64% after RN. RN should be reserved for patients with massive renal tumors in whom PN is not an option. Increased training in PN and its wider application is essential. Copyright © 2008 by Current Medicine Group LLC.
Keywords: cancer surgery; review; cancer diagnosis; metastasis; risk factors; risk factor; kidney neoplasms; nephrectomy; risk assessment; chronic disease; kidney; partial nephrectomy; kidney tumor; chronic kidney disease; cardiovascular diseases; glomerulus filtration rate; kidney cortex; kidney diseases
Journal Title: Current Urology Reports
Volume: 9
Issue: 1
ISSN: 1527-2737
Publisher: Springer  
Date Published: 2008-01-01
Start Page: 15
End Page: 21
Language: English
DOI: 10.1007/s11934-008-0005-4
PUBMED: 18366969
PROVIDER: scopus
DOI/URL:
Notes: --- - "Cited By (since 1996): 7" - "Export Date: 17 November 2011" - "Source: Scopus"
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  1. Paul Russo
    548 Russo