Onkologie. 2017:11(1):14-18 | DOI: 10.36290/xon.2017.004

The update on treatment surgical management of renal tumors

Petr Macek

Urologická klinika 1. LF UK a VFN v Praze

Surgery is a method of choice for the management of localized and locally-advanced renal tumors. In cT1a (up to 4 cm) tumors

nephron-sparing approach (= partial nephrectomy) is current recommended standard, provided it is technically feasible and there

are no contraindications. The amount of nephron-sparing surgeries increases over time also owing to new technologies such as 3D

imaging during surgery, robot-assisted surgery, better hemostatic instruments and greater experience, which all lead to shorter

or no warm ischemia during nephron-sparing surgery. However, there is no long-term functional benefit in elderly patients over

75 years of age. Nevertheless, if preservation of functional parenchyma is needed, thermal ablation methods (radiofrequency ablation

or cryoablation) or active surveillance are possible. In management of locally advanced renal tumors R0 surgery is intended

as adjuvant systemic treatment in not yet the standard. For selected patients with distant metastases surgery, metastasectomy,

is possible. However, only complete metastasectomy of all lesions brings better overall survival.

Keywords: renal tumor, surgical management, partial nephrectomy

Published: February 1, 2017  Show citation