Onkológia 5/2010

Surgical treatment of renal cell carcinomas

Renal cell carcinoma (RCC) is the third most frequent urological malignancy. In majority of patients it is diagnosed in localized stage. Surgical treatment remains the only curative approach in localized RCC and contributes to the therapy of disseminated disease as well. Whenever technically feasible, nephron.sparing surgery is the standard procedure for renal tumors up to the diameter of 7 cm. However, open partial nephrectomy still remains the integral part of care in patients with renal masses in a solitary kidney or the thrombus in the vena cava. A minimal tumor-free surgical margin following partial resection of RCC is sufficient to avoid local recurrence. There is an increased risk of local tumor recurrence in larger-size tumors (> 7 cm) treated by nephron sparing surgery or when there is a positive margin. Laparoscopic radical nephrectomy is recommended in T2 RCC. Larger tumors are safely treated by open radical nephrectomy.

Keywords: renal cell carcinoma, radical nephrectomy, nephron sparing surgery, alternative therapeutic methods