Partial nephrectomy for incidental renal cell carcinoma.

Overview

OBJECTIVE: To evaluate the role of nephron-sparing surgery in patients with incidental renal cell carcinoma and a normal contralateral kidney. PATIENTS AND METHODS: A total of 230 patients underwent curative surgery for unilateral renal cancer between 1979 and 1991. Of these, 41 had a partial nephrectomy. The numbers of patients who underwent partial or radical nephrectomy over the course of the study are compared. RESULTS: The number of partial compared to total nephrectomies increased from 8% in 1979-84, to 20% in 1984-88 and 30% in 1989-91. This reflected increased detection of incidental renal tumours by radiological imaging. The local recurrence rate in those patients who underwent partial nephrectomy was 2% and survival was 95%, with an average follow-up of 3 years (range, 2-13). CONCLUSION: Nephron-sparing excision of small, incidental renal tumours achieved comparable early results to radical nephrectomy.