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Partial nephrectomy: The rationale for expanding the indications

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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.

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Authors and Affiliations

  1. Department of Urology, Memorial Sloan-Kettering Cancer Center, 1275 York Ave., 10021, New York, NY

    Paul Russo MD, Manlio Goetzl MD, Rachel Simmons MD & Jared Katz MD

  2. Department of Medicine, Memorial Sloan-Kettering Cancer Center, 1275 York Ave., 10021, New York, NY

    Robert Motzer MD

  3. Department of Pathology, Memorial Sloan-Kettering Cancer Center, 1275 York Ave., 10021, New York, NY

    Victor Reuter MD

Authors
  1. Paul Russo MD
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  2. Manlio Goetzl MD
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  3. Rachel Simmons MD
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  4. Jared Katz MD
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  5. Robert Motzer MD
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  6. Victor Reuter MD
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Correspondence to Paul Russo MD.

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Russo, P., Goetzl, M., Simmons, R. et al. Partial nephrectomy: The rationale for expanding the indications. Annals of Surgical Oncology 9, 680–687 (2002). https://doi.org/10.1007/BF02574485

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  • DOI: https://doi.org/10.1007/BF02574485

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