Partial nephrectomy: The rationale for expanding the indications Journal Article


Authors: Russo, P.; Goetzl, M.; Simmons, R.; Katz, J.; Motzer, R.; Reuter, V.
Article Title: Partial nephrectomy: The rationale for expanding the indications
Abstract: Background: We report preliminary results of partial nephrectomy for renal tumors of ≥4 cm in 39 patients with the intent of extending the indications for kidney-sparing surgery. Methods: From July 1989 to October 2001, 39 patients underwent a partial nephrectomy for renal cortical tumors >4 cm in maximum diameter. Fourteen (36%) had the procedure performed for essential reasons, and 25 (64%) had an elective kidney-sparing operation. We evaluated tumor location and histology, perioperative renal function, and postoperative complications. Results: There were 20 conventional clear-cell (51%), 13 papillary (33%), 4 chromophobe (10%), and 3 oncocytomas (8%) with a median tumor size of 5 cm. After a median follow-up of 13 months, 36 patients had no evidence of disease, 1 patient had died as a result of other causes, and 2 patients who had essential operations were alive with disease. Twenty-three patients (70%) maintained normal postoperative renal function. Of six patients with moderate preoperative renal dysfunction, five (83%) had no change in postoperative renal function and only one patient required short-term dialysis. Conclusions: With careful patient selection, partial nephrectomy can be effectively used to treat patients with renal cortical tumors >4 cm in diameter. The benefits of this approach include the effective local tumor control while at the same time preserving maximum renal function.
Keywords: adult; clinical article; controlled study; aged; aged, 80 and over; disease-free survival; middle aged; survival rate; patient selection; cancer staging; neoplasm staging; treatment indication; oncocytoma; kidney neoplasms; nephrectomy; partial nephrectomy; kidney tumor; cancer size; new york city; clear cell carcinoma; papillary carcinoma; chromophobe adenoma; renal tumors; tumor staging; humans; human; male; female; article; kidney-sparing surgery
Journal Title: Annals of Surgical Oncology
Volume: 9
Issue: 7
ISSN: 1068-9265
Publisher: Springer  
Date Published: 2002-08-01
Start Page: 680
End Page: 687
Language: English
DOI: 10.1245/aso.2002.9.7.680
PUBMED: 12167583
PROVIDER: scopus
DOI/URL:
Notes: Export Date: 14 November 2014 -- Source: Scopus
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MSK Authors
  1. Paul Russo
    581 Russo
  2. Robert Motzer
    1243 Motzer
  3. Victor Reuter
    1228 Reuter
  4. Jared   Katz
    13 Katz
  5. Manlio   Goetzl
    1 Goetzl