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Статті в журналах з теми "Renal cell carcinoma, radical nephrectomy, partial nephrectomy, renal function"

Автор: Grafiati

Опубліковано: 10 березня 2023

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1

Chiu, Yichun, and Allen W. Chiu. "Renal Preservation Therapy for Renal Cell Carcinoma." International Journal of Surgical Oncology 2012 (2012): 1–6. http://dx.doi.org/10.1155/2012/123596.

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Renal preservation therapy has been a promising concept for the treatment of localized renal cell carcinoma (RCC) for 20 years. Nowadays partial nephrectomy (PN) is well accepted to treat the localized RCC and the oncological control is proved to be the same as the radical nephrectomy (RN). Under the result of well oncological control, minimal invasive method gains more popularity than the open PN, like laparoscopic partial nephrectomy (LPN) and robot assisted laparoscopic partial nephrectomy (RPN). On the other hand, thermoablative therapy and cryoablation also play an important role in the renal preservation therapy to improve the patient procedural tolerance. Novel modalities, but limited to small number of patients, include high-intensity ultrasound (HIFU), radiosurgery, microwave therapy (MWT), laser interstitial thermal therapy (LITT), and pulsed cavitational ultrasound (PCU). Although initial results are encouraging, their real clinical roles are still under evaluation. On the other hand, active surveillance (AS) has also been advocated by some for patients who are unfit for surgery. It is reasonable to choose the best therapeutic method among varieties of treatment modalities according to patients' age, physical status, and financial aid to maximize the treatment effect among cancer control, patient morbidity, and preservation of renal function.

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2

Miyamoto, Katsutoshi, Shogo Inoue, Mitsuru Kajiwara, Jun Teishima, and Akio Matsubara. "Comparison of Renal Function after Partial Nephrectomy and Radical Nephrectomy for Renal Cell Carcinoma." Urologia Internationalis 89, no. 2 (2012): 227–32. http://dx.doi.org/10.1159/000339969.

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3

Jhaveri, Kenar D., Phillip Pierorazio, and Susie L. Hu. "Partial versus radical nephrectomy for renal cell carcinoma." Journal of Onco-Nephrology 2, no. 2-3 (June 2018): 69–77. http://dx.doi.org/10.1177/2399369318817323.

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Chronic kidney disease risk is increased among patients with renal cell carcinoma, particularly for those with preexisting chronic kidney disease (including proteinuria) but also for those with comorbidities such as diabetes mellitus, hypertension, and obesity. Among those with small renal masses without complex disease, partial nephrectomy should be prioritized given favorable pathologic prognosis and mortality related to cardiovascular disease or chronic kidney disease. Nephrologists should actively participate in a multidisciplinary team to help formulate individualized treatment which will help preserve residual kidney function where possible.

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4

Tityaev, Igor I., Igor V. Tikhonov, Boris A. Neymark, Sergey S. Andreev, Svetlana V. Andreeva, Konstantin V. Udalov, and Denis S. Kasyanov. "Hemodynamics and functional state of the contralateral kidney in the early postoperative period after surgical treatment of kidney cancer." Urology reports (St. - Petersburg) 11, no. 3 (October 11, 2021): 227–33. http://dx.doi.org/10.17816/uroved76051.

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AIM: To study the hemodynamics and functional state of the renal tissue of the contralateral kidney in the early postoperative period after surgical treatment of kidney cancer. MATERIALS AND METHODS: The prospective study included 58 patients with renal cell carcinoma, 36 (62.1%) of whom underwent radical nephrectomy, and 22 (37.9%) underwent partial nephrectomy. Tumor sizes ranged from 1.0 to 12.0 cm. All patients before surgery and in the early postoperative period underwent ultrasound examination of the structure and size of the kidneys, Doppler ultrasonography of the renal vessels, biomicroscopy of the bulbar conjunctiva, measured peripheral blood pressure, determined the glomerular filtration rate (GFR) and performed a coagulogram. The control group included 16 healthy adults. RESULTS: In 83.3% of patients after radical nephrectomy and in 13.6% of patients after partial nephrectomy a tendency towards an increase in blood pressure compared with the initial values was noted by the 2-4th day after the operation. By the 5th day after surgery, the volume of the only kidney remaining after radical nephrectomy increased by an average of 4% (from 126.1 1.4 to 131.2 2.1 cm3, p 0.05), while after partial nephrectomy has not changed reliably. After surgery, a decrease in GFR was detected in 34 (58.6%; p 0.05) patients, including after radical nephrectomy (n = 28) up to 73.4 8.2 ml / min / 1.73 m2, after partial nephrectomy (n = 6) up to 98.2 3.4 ml / min / 1.73 m2. Doppler ultrasonography of the vessels of a single kidney in patients after radical nephrectomy showed a moderate increase in linear blood flow, an increase in the resistance index in the main trunk of the renal artery, and a decrease in the pulsation index in the segmental and arc arteries. In patients after partial nephrectomy in the contralateral kidney these changes were not observed. When performing biomicroscopy of the bulbar conjunctiva in 83.3% of patients after radical nephrectomy and in 13.6% of patients after partial nephrectomy, changes in the microvasculature were revealed: narrowing of arterioles, expansion of venules, slowing of venular and capillary blood flow. Before the operation and in the early postoperative period, the content of fibrinogen and soluble fibrin-monomer complex in the blood of patients with renal cell carcinoma was significantly higher than in the control group. CONCLUSIONS: In patients with renal cell carcinoma, changes in the contralateral kidney in the early postoperative period after radical nephrectomy are significantly more pronounced than after partial nephrectomy, and are accompanied by changes in systemic and local hemodynamics and kidney function. The results of the study confirm the feasibility of performing organ-preserving surgeries in patients with renal cell carcinoma.

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5

Chapman, David, Ron Moore, Scott Klarenbach, and Branko Braam. "Residual renal function after partial or radical nephrectomy for renal cell carcinoma." Canadian Urological Association Journal 4, no. 5 (April 18, 2013): 337. http://dx.doi.org/10.5489/cuaj.909.

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Анотація:

Renal cell carcinoma (RCC) is often detected incidentally andearly. Currently, open partial nephrectomy and laparoscopic totalnephrectomy form competing technologies. The former is invasive,but nephron-sparing; the other is considered less invasive but withmore loss of renal mass. Traditionally, emphasis has been placedon oncologic outcomes. However, a patient with an excellentoncologic outcome may suffer from morbidity and mortality relatedto renal failure. Animal models with hypertension and diabeticrenal disease indicate accelerated progression of pre-existing diseaseafter nephrectomy. Patients with RCC are older and they havea high prevalence of diabetes and hypertension. The progressionof renal failure may also be accelerated after a nephrectomy. Ouranalysis of the available literature indicates that renal outcomes inRCC patients after surgery are relatively poorly defined. A strategyto systematically evaluate the renal function of patients with RCC,with joint discussion between the nephrologist and the oncologicteam, is strongly advocated.L’hypernéphrome est souvent décelé fortuitement et au stade précoce.Actuellement, la néphrectomie partielle par voie ouverteet la néphrectomie totale par laparoscopie sont des technologiesconcurrentes. Tandis que la première est plus invasive, mais permetl’épargne des néphrons, la seconde est moins invasive maisentraîne une perte plus importante de masse rénale. Par le passé,on a mis l’emphase sur les résultats d’un point de vue oncologique.Cependant, un patient pour qui la chirurgie donne d’excellents résultatsen matière d’élimination de la tumeur pourrait présenter unemorbidité et une mortalité en lien avec une insuffisance rénale. Desmodèles animaux de néphropathie avec hypertension et diabèteindiquent une évolution accélérée des maladies préexistantes aprèsla néphrectomie. Les patients présentant un hypernéphrome sontplus âgés; la prévalence du diabète et de l’hypertension est élevée.L’évolution de l’insuffisance rénale peut aussi être accélérée aprèsla néphrectomie. Notre analyse des articles publiés montre que lesrésultats sur le plan de la fonction rénale après une chirurgie pourtraiter un hypernéphrome sont relativement mal définis. Une stratégiefondée sur une évaluation systématique de la fonction rénale despatients atteints d’hypernéphrome, avec discussion entre le néphrologueet l’équipe de soins oncologiques, est fortement encouragée.

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6

Kim, Dae Y., Christopher G. Wood, and Jose A. Karam. "Treating the Two Extremes in Renal Cell Carcinoma: Management of Small Renal Masses and Cytoreductive Nephrectomy in Metastatic Disease." American Society of Clinical Oncology Educational Book, no. 34 (May 2014): e214-e221. http://dx.doi.org/10.14694/edbook_am.2014.34.e214.

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OVERVIEW: The incidental renal mass represents a heterogeneous group that contains both benign and malignant pathologies. The majority of renal cell carcinomas are discovered incidentally, without the presence of symptoms directly related to the mass, and are closely associated with the term small renal masses because of the discovery before the onset of symptoms. In general, small renal masses are defined as 4 cm or smaller, and may account for greater than half of renal cell carcinoma diagnosis. The use of renal mass biopsy may offer additional pathological information but the clinician must be reminded of the technical and diagnostic limitations of renal mass biopsy. Patient-dependent factors, such as life expectancy and comorbidities, guide the management of small renal masses, which include active surveillance, partial nephrectomy, radical nephrectomy, and ablative techniques (cryoablation and radiofrequency ablation). Partial nephrectomy has demonstrated durable oncologic control for small renal masses while preserving renal function and, if feasible, is the current treatment of choice. In the other extreme of the renal cell carcinomas spectrum and in the presence of metastatic disease, the removal of the renal primary tumor is termed cytoreductive nephrectomy. Two randomized trials (SWOG 8949 and EORTC 30947) have demonstrated a survival benefit with cytoreductive nephrectomy before the initiation of immunotherapy. These two studies have also been the motivation to perform cytoreductive nephrectomy in the targeted therapy era. Currently, there are two ongoing randomized prospective trials accruing to investigate the timing and relevance of cytoreductive nephrectomy in the contemporary setting of targeted therapy.

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7

Jitpraphai, Siros, Chaiyong Nualyong, Tawatchai Taweemonkongsap, Sittiporn Srinualnad, Teerapon Amornwesukit, Sunai Leewansangtong, Bansithi Chaiyaprasithi, et al. "Renal function after nephron-sparing surgery versus radical nephrectomy in localized renal cell carcinoma (T1)." Insight Urology 41, no. 2 (December 8, 2020): 1–8. http://dx.doi.org/10.52786/j.1.

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Objective: To evaluate renal function (GFR) after radical nephrectomy compared to partial nephrectomy in stage T1 renal cell carcinoma patients between 2005 and 2015. Material and Method: Retrospective chart review of 409 patients who were diagnosed with renal cell carcinoma (T1) and treated with radical nephrectomy (RN) or partial nephrectomy (PN) between 2005 and 2015 (RN=136, PN=92); 228 patients with pathologically confirmed pT1 remained for analysis and were then evaluated for their estimated glomerular filtration rate (eGFR) after the surgery. Results: There were a total of 228 (149 males and 79 females) T1 RCC patients; 136 patients were T1a with RN (57.8%) and 92 with PN (42.2%). Median follow-up was 58 months and 35 months for the RN and PN groups. From the analysis, post-operative eGFR of the RN group was decreased from 77.49 to 59.61 ml/min/1.73m2 and the PN group was decreased from 78.85 to 69.9 ml/min/1.73m2. The comparative eGFR between the 2 groups at 1 month had a significant difference (p-value<0.05). eGFR at 3 months (50.24 in RN vs 64.67 in PN), 6 months (47.98 vs 64.51), 3 years (48.79 vs 67.22) and 5 years (52.63 vs 73.59) were also significantly altered between the 2 groups. The tumor recurrence rate was not significantly different between RN and PN. Conclusion: We found that patients treated with PN had superior post-operative renal function compared with RN. However, there was no difference in the tumor recurrence rate between the 2 groups after a follow-up of 10 years.

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8

Kulchenko, N. G. "TREATMENT OF LOCALIZED RENAL CANCER." South Russian Journal of Cancer 1, no. 1 (March 7, 2020): 69–75. http://dx.doi.org/10.37748/2687-0533-2020-1-1-6.

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Renal cell carcinoma (RCC) accounts for 3.9 % of all cancers. In 2018, 24,291 and 63,990 new cases of RCC were recorded in Russia and the US, respectively. The most common approach to early stage RCC treatment consists in either radical or partial nephrectomy. This article presents a clinical case of the successful treatment of a localized renal cell carcinoma T3аN0M0 in a 65-year-old man. 8 weeks after the performed kidney resection, the biochemical blood parameters and glomerular filtration rate did not significantly differ from the initial values (p > 0.05). A control CT examination of the abdominal cavity and the retroperitoneal space (after 12 weeks) detected no enlarged regional, paraaortic and paracanal lymph nodes. Partial nephrectomy is considered to be an alternative surgical treatment of localized RCC forms due to its potential for maximal organ preservation. Partial nephrectomy should be a method of choice in cases where it is technically and strategically feasible, since this type of surgical intervention provides for a better preservation of renal function under a lower risk of postoperative complications.

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9

Maric, Predrag, Predrag Aleksic, Branko Kosevic, Mirko Jovanovic, Vladimir Bancevic, Dejan Simic, and Nemanja Rancic. "Elective partial and radical nephrectomy in patients with renal cell carcinoma in CT1B stadium." Vojnosanitetski pregled, no. 00 (2021): 8. http://dx.doi.org/10.2298/vsp200520008m.

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Background/Aim. In renal cell carcinoma (RCC) the choice of surgical technique, radical (RN) or partial nephrectomy (PN) is still centre dependant because there still are no absolute recommendations for this approach. This study aims to analyze the oncological aspects, time until recurrent disease appears and cancer-specific survival in patients with RCC in T1bN0?0 depending on the type of surgical procedure partial or radical nephrectomy. Methods. A clinical observational study of a series of cases was conducted that analyzed data of 154 patients operated in our institution with a mean follow up a period not less than five years. The inclusion criteria included: renal tumours 4-7 cm, histopathological confirmation of RCC, absence of metastasis and normal serum creatinine. Exclusion criteria included: the presence of other malignancies, solitary functional kidney or comorbidities that can compromise renal function, bilateral tumours or unilateral multiple tumours. Results. The study analyzed data of 154 patients, 97 radical nephrectomies and 57 patients that underwent partial nephrectomy. Analyzing cancer-specific survival in four patients with RN there was a disease advancement that led to a lethal outcome, one PN patient died as a result of local relapse and distant metastasis. Conclusion. Based on our results PN is a good and safe treatment option for patients with RCC in T1b stadium. Partial nephrectomy offers a similar tumour control and better cancer-specific survival.

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10

O'Malley, Rebecca Leigh, Matthew H. Hayn, Greg Wilding, and Thomas Schwaab. "Population-based analysis of cancer control of partial nephrectomy for high-risk localized renal cell carcinoma." Journal of Clinical Oncology 30, no. 5_suppl (February 10, 2012): 385. http://dx.doi.org/10.1200/jco.2012.30.5_suppl.385.

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385 Background: Partial nephrectomy (PN) has reported equivalent oncologic outcomes with superior renal function outcomes when compared to radical nephrectomy (RN) for treatment of localized renal cell carcinoma (RCC). Whether PN provides adequate cancer control in high risk disease is unclear. To clarify, survival outcomes were compared between those who underwent RN and PN for high risk RCC. Methods: Using the Surveillance, Epidemiology, and End Results database patients with RCC who underwent PN or RN for a localized tumor ≤ 7cm were identified. Cancer-specific (CSS) and overall survival (OS) were compared between those with high risk disease (defined as poorly or undifferentiated grade and/or pathologic stage T3) who underwent PN or RN. Results: Of 51,183 patients with localized RCC ≤ 7cm, 24.9% had high risk disease, 85.2% and 14.8% of which underwent RN and PN, respectively. Five-year CSS was superior in the PN group vs. the RN group (93.3% vs. 86.0%, p<0.001). On multivariable analysis undergoing RN was no longer predictive of CSS (HR 1.23, p=0.08). Similarly, 5-year OS was superior in the PN versus RN group (79.5% vs. 70.1%, p<0.001). RN remained independently associated with poor OS on multivariable analysis (HR 1.16, p=0.031). Propensity analysis accounting for factors affecting selection for type of nephrectomy produced similar results. RN did not influence CSS but portended a 20% increased risk of death from all causes (p=0.008). Conclusions: In patients with high risk RCC, partial nephrectomy is associated with improved OS and does not compromise cancer control as compared to radical nephrectomy.

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11

Yang, Feiya, Qiang Zhou, and Nianzeng Xing. "Comparison of survival and renal function between partial and radical laparoscopic nephrectomy for T1b renal cell carcinoma." Journal of Cancer Research and Clinical Oncology 146, no. 1 (November 1, 2019): 261–72. http://dx.doi.org/10.1007/s00432-019-03058-z.

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12

Fandella, A., F. Merlo, L. Maccatrozzo, and G. Anselmo. "Our Experience in Conservative Treatment." Urologia Journal 59, no. 6 (December 1992): 43–46. http://dx.doi.org/10.1177/039156039205900611.

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From January 1983 to September 1992 conservative surgery was performed for renal tumors in 29 patients with renal cell carcinoma; bilateral neoplasia (8 patients), anatomical or functional solitary kidney (13 patients) and 8 patients with a contralateral healthy kidney (small, incidental, unique renale neoplasm). We performed partial nephrectomy with excision of a margin of normal tissue for oncological safety rather than enucleation. In our series we especially studied renal function by radionuclide imaging, in those with a follow-up of over 12 months. 23 patients are alive with stable renal function and no evidence of malignancy. Recently we have tried to utilize flow cytometry as an intra-operative test to obtain the result of this test at the same time as the intra-operative pathological examination, so as to have more elements for deciding on conservative surgery. Pre-intra-operative cytometric knowledge could be the new criterion for a well-considered decision between radical or conservative procedures.

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13

Deng, Huan, Yan Fan, Feifei Yuan, Li Wang, Zhengdong Hong, Jinfeng Zhan, and Wenxiong Zhang. "Partial nephrectomy provides equivalent oncologic outcomes and better renal function preservation than radical nephrectomy for pathological T3a renal cell carcinoma: A meta-analysis." International braz j urol 47, no. 1 (February 2021): 46–60. http://dx.doi.org/10.1590/s1677-5538.ibju.2020.0167.

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14

Takagi, Toshio, Tsunenori Kondo, Jyunpei Iizuka, Hirohito Kobayashi, Yasunobu Hashimoto, Hayakazu Nakazawa, Fumio Ito, and Kazunari Tanabe. "Postoperative renal function after partial nephrectomy for renal cell carcinoma in patients with pre-existing chronic kidney disease: A comparison with radical nephrectomy." International Journal of Urology 18, no. 6 (April 11, 2011): 472–76. http://dx.doi.org/10.1111/j.1442-2042.2011.02765.x.

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15

Mariusdottir, Elin, Eirikur Jonsson, Valur T. Marteinsson, Martin I. Sigurdsson, and Tomas Gudbjartsson. "Kidney function following partial or radical nephrectomy for renal cell carcinoma: A population-based study." Scandinavian Journal of Urology 47, no. 6 (April 18, 2013): 476–82. http://dx.doi.org/10.3109/21681805.2013.783624.

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16

Petralia, G., R. Bertini, U. Capitanio, E. Strada, F. C. Sozzi, D. Angiolilli, R. Matloob, et al. "618 IDENTIFYING FACTORS AFFECTING RENAL FUNCTION IN PATIENTS WITH PT1B RENAL CELL CARCINOMA WHO UNDERWENT RADICAL OR PARTIAL NEPHRECTOMY." European Urology Supplements 10, no. 2 (March 2011): 201. http://dx.doi.org/10.1016/s1569-9056(11)60607-6.

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17

Mühlbauer, Julia, Karl‐Friedrich Kowalewski, Margarete T. Walach, Stefan Porubsky, Frederik Wessels, Philipp Nuhn, Nina Wagener, and Maximilian C. Kriegmair. "Partial nephrectomy preserves renal function without increasing the risk of complications compared with radical nephrectomy for renal cell carcinomas of stages pT2–3a." International Journal of Urology 27, no. 10 (August 11, 2020): 906–13. http://dx.doi.org/10.1111/iju.14326.

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18

Choi, S. M., H. G. Jeon, T. S. Kim, K. J. Ko, H. S. Ryoo, S. J. Shin, S. W. Lee, et al. "650 Does metabolic syndrome affect renal function or survival of patients underwent partial or radical nephrectomy for renal cell carcinoma?" European Urology Supplements 13, no. 1 (April 2014): e650-e650b. http://dx.doi.org/10.1016/s1569-9056(14)60640-0.

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Nohara, Takahiro. "Editorial Comment to Postoperative renal function after partial nephrectomy for renal cell carcinoma in patients with pre-existing chronic kidney disease: A comparison with radical nephrectomy." International Journal of Urology 18, no. 6 (May 23, 2011): 477. http://dx.doi.org/10.1111/j.1442-2042.2011.02773.x.

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20

Ryan, Stephen, Ahmet Bindayi, Aaron Bloch, Ryan Nasseri, Zachary Hamilton, Kendrick Yim, Madhumitha Reddy, et al. "Impact of pre-existing diabetes mellitus on survival in stage I renal cell carcinoma." Journal of Clinical Oncology 36, no. 6_suppl (February 20, 2018): 676. http://dx.doi.org/10.1200/jco.2018.36.6_suppl.676.

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676 Background: AUA guidelines recommend consideration of nephron sparing surgery in patients with comorbidities that are likely to impact renal function, such as diabetes mellitus (DM). We compared the impact of partial nephrectomy (PN) and radical nephrectomy (RN) on overall survival (OS) in patients with pre-existing DM and Stage I Renal Cell Carcinoma (RCC). Methods: Multicenter retrospective analysis of surgically treated Stage I RCC from 2005-16 with or without DM. Primary outcome was OS analyzed by DM+ or DM- and surgical approach (PN or RN) for AJCC Stage I. Logistic (OR) and Cox (HR) regression were utilized for OS. Results: 2173 patients were analyzed (1223 RN, 1819 PN, 555 DM+, 2487 DM-) with mean follow-up of 49.1 months. Increasing Age (OR 1.028, p = .009), RN (OR 2.446, p = .001), and most recent eGFR < 45 (OR 2.306 p = .002) remained significant on multivariate analysis for OS (Table 1). In the PN subgroup, DM+ or DM- was not associated with decreased OS (HR 1.48 p = 0.19). DM+ was associated with decreased OS in the RN subgroup (HR 1.97 p = 0.005). Conclusions: In Stage I RCC, DM and RN negatively impacted OS, while only RN remained significant on MVA. Subgroup analysis of PN showed that OS was similar in DM- and DM+ patients, but diagnosis of DM had a profound impact on OS in the RN group. This supports the guideline statements and offers evidence that urologists should prioritize nephron sparing surgery in patients with DM and Stage I Renal Cell Carcinoma.[Table: see text]

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Jeon, Hwang Gyun, In Hyuck Gong, Jin Ho Hwang, Don Kyung Choi, Seung Ryeol Lee, and Dong Soo Park. "Prognostic significance of preoperative kidney volume for predicting renal function in renal cell carcinoma patients receiving a radical or partial nephrectomy." BJU International 109, no. 10 (August 25, 2011): 1468–73. http://dx.doi.org/10.1111/j.1464-410x.2011.10531.x.

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Mühlbauer, Julia, Johannes de Gilde, Michael Mueller-Steinhardt, Stefan Porubsky, Margarete Walach, Philipp Nuhn, Harald Klüter, Nina Wagener, and Maximilian C. Kriegmair. "Perioperative Blood Transfusion Is a Predictor of Acute and Chronic Renal Function Deterioration after Partial and Radical Nephrectomy for Renal Cell Carcinoma." Urologia Internationalis 104, no. 9-10 (2020): 775–80. http://dx.doi.org/10.1159/000509206.

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Zazzara, Michele, Roberto Carando, Arjan Nazaraj, Marcello Scarcia, Michele Romano, and Giuseppe Mario Ludovico. "Nephron sparing surgery for the treatment of renal masses: A single center experience." Urologia Journal 88, no. 3 (February 10, 2021): 206–11. http://dx.doi.org/10.1177/0391560321993557.

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Background: Nowadays, the partial nephrectomy (PN) not only is considered oncological equivalent to radical nephrectomy as renal tumor’s treatment, but has also give benefits in quality of life and overall survival of patients. Objectives: The primary objective of the present study was to report our single center experience with NSS, predominantly performed by a robot assisted access, in a high-volume center with large experience with minimally invasive surgery. Methods: Between June 2018 and January 2020, a consecutive series of 109 patients (pts) with a renal mass suspicious of renal cell carcinoma, feasible of NSS, detected by ultrasound and abdominal computed tomography (CT), underwent NSS and they were included in a prospectively maintained institutional database. Baseline demographics and clinical characteristics, perioperative and postoperative parameters, pathological data were recorded. Results: The mean clinical maximum CT tumor diameter was 37.3 ± 19.6 mm (median 31.5 mm; interquartile range 25–45 mm). PADUA risk was low in 54 pts (49.5%), intermediate in 48 pts (44.0%), high in seven pts (6.4%). The clinical T stage was mostly pT1a (70.6%). NSS was performed by open surgery in nine pts (8.3%), laparoscopy in one pts (0.9%) and was robot assisted in 99 pts (90.8%). A simple enucleation was performed in 67 pts (61.5%), an enucleoresection was performed in 37 pts (33.9%) and a partial nephrectomy was performed in five pts (4.6%). Warm ischemia was performed in 41 pts (37.6%), with a mean warm ischemia time of 5.1 ± 7.1 min. The mean pathological maximum tumor diameter was 35.5 ± 21.7 mm (median 30 mm; interquartile range 22–40 mm). Overall PSM rate was 11.9% (13 pts). In 78% of cases no complication was recorded. No major complications (grade III-IV-V) were noted. Conclusion: Our findings suggest that NSS is a safe, reproducible and minimally invasive approach as treatment of small renal masses. NSS permits to achieve a fine oncological management without any worsening of renal function.

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Ahmad, Ardalan E., and Antonio Finelli. "Renal Function Outcomes Following Radical or Partial Nephrectomy for Localized Renal Cell Carcinoma: Should Urologists Rely on Preoperative Variables to Predict Renal Function in the Long Term?" European Urology 75, no. 5 (May 2019): 773–74. http://dx.doi.org/10.1016/j.eururo.2018.12.027.

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Chung, Jae Seung, Nak Hoon Son, Sang Eun Lee, Sung Kyu Hong, Sang Chul Lee, Cheol Kwak, Sung Hoo Hong, Yong June Kim, Seok Ho Kang, and Seok-Soo Byun. "Overall survival and renal function after partial and radical nephrectomy among older patients with localised renal cell carcinoma: A propensity-matched multicentre study." European Journal of Cancer 51, no. 4 (March 2015): 489–97. http://dx.doi.org/10.1016/j.ejca.2014.12.012.

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26

Kondo, Tsunenori. "Editorial Comment from Dr Kondo to Partial nephrectomy preserves renal function without increasing the risk of complications compared with radical nephrectomy for renal cell carcinomas of stages pT2–3a." International Journal of Urology 27, no. 10 (August 11, 2020): 915. http://dx.doi.org/10.1111/iju.14347.

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Bertolo, Riccardo, Chiara Cipriani, Matteo Ferro, and Pierluigi Bove. "Editorial Comment from Dr Bertolo et al . to Partial nephrectomy preserves renal function without increasing the risk of complications compared with radical nephrectomy for renal cell carcinomas of stages pT2–3a." International Journal of Urology 27, no. 10 (August 11, 2020): 914. http://dx.doi.org/10.1111/iju.14334.

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28

Mitsui, Yosuke, and Takuya Sadahira. "Editorial Comment from Dr Mitsui and Dr Sadahira to Partial nephrectomy preserves renal function without increasing the risk of complications compared with radical nephrectomy for renal cell carcinomas of stages pT2–3a." International Journal of Urology 27, no. 10 (August 11, 2020): 913. http://dx.doi.org/10.1111/iju.14333.

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Dutt, Raksha, Margaret Frances Meagher, Dattatraya Patil, Kazutaka Saito, Devin Patel, Fady Ghali, Cathrine Keiner, et al. "Impact of diabetes mellitus on functional and survival outcomes in renal cell carcinoma: An international multicenter study." Journal of Clinical Oncology 38, no. 6_suppl (February 20, 2020): 666. http://dx.doi.org/10.1200/jco.2020.38.6_suppl.666.

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666 Background: Functional decline is an important consideration in the surgical treatment of renal cell carcinoma (RCC). While radical nephrectomy (RN) may be associated with increased risk of functional decline compared to partial nephrectomy (PN), the modifying effect of DM, an independent risk factor of chronic kidney disease (CKD), is not completely understood. We investigated the relationship between DM and decline in kidney function following surgery for RCC, and impact on overall survival (OS) in patients with RCC. Methods: A multicenter dataset of RCC patients undergoing PN and RN was utilized. The cohort was divided based on DM status [DM vs No DM (NDM)]. Multivariable analysis (MVA) elucidated potential variables associated with decline in kidney function [de novo estimated glomerular filtration rate (eGFR) < 45 ml/min/1.73m2 and de novo eGFR < 30 ml/min/1.73m2] and worse all-cause mortality (ACM). Kaplan-Meier analysis (KMA) was used to investigate OS rates in DM and NDM patients undergoing RN and PN. Results: 2928 patients were analyzed (DM = 406, NDM = 2522). On MVA, independent risk factors associated with eGFR < 45 included age (OR = 1.07, p < 0.001), DM (OR = 1.88, p < 0.001), tumor size (OR = 1.03, p = 0.032), and RN (OR = 1.54, p < 0.001). Variables associated with eGFR < 30 included age (OR = 1.05, p < 0.001), African American race (OR = 2.18, p < 0.001), and DM (OR = 2.09, p < 0.001). MVA for ACM revealed age (OR = 1.02, p = 0.002), HTN (OR = 2.47, p < 0.001), tumor size (OR = 1.12, p < 0.001), tumor grade (OR = 1.87, p < 0.001), RN (OR = 1.55, p = 0.011), eGFR < 45 (OR = 1.40, p = 0.03), and eGFR < 30 (OR = 1.87, p = 0.026) to be independently associated. On KMA, 5-year OS stratified by DM status showed that DM is associated with worse OS for RN patients (p = 0.047), but not for PN patients (p = 0.944). Conclusions: Presence of DM is an independent risk factor for renal functional decline and development of worsening CKD is a risk factor for worsening ACM. Furthermore, decreased survival in DM patients was associated with RN recipients but not with PN recipients. Presence of DM may be considered a strong indicator for nephron preservation management strategies when safe and feasible in RCC patients.

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Wong, Kevin, Michael Shusterman, Sanjay Goel, Abdissa Negassa, Juan Lin, Janaki Neela Sharma, and Benjamin Adam Gartrell. "Racial diversity among histology of renal cell carcinoma at an urban medical center." Journal of Clinical Oncology 36, no. 6_suppl (February 20, 2018): 622. http://dx.doi.org/10.1200/jco.2018.36.6_suppl.622.

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622 Background: Non-Hispanic Blacks (NHB) with renal cell carcinoma (RCC) are more likely to have papillary RCC (pRCC) than Non-Hispanic Whites (NHW). Little is known about the histology of RCC in Hispanics (H). The Montefiore-Einstein Cancer Center (MECC) serves a diverse population in the Bronx, NY. We sought to investigate histological subtype-specific associations with established RCC risk factors in an ethnically diverse patient population to elucidate prospective relationships between those factors and racial differences in RCC histology. Methods: : The MECC tumor registry was used to identify patients ≥18 years of age treated with partial or radical nephrectomy between January 2000 and December 2015. An institutional software program and individual chart review were used to obtain demographic data (including self-reported race, age, and sex), pathology data, and RCC risk factors (hypertension, diabetes, smoking status, renal function, weight). Data were modeled by multinomial logistic regression to estimate odds ratios (ORs) and 95% CIs. Results: 1010 RCC cases were identified (232 NHW, 383 NHB, 181 H, and 214 other). Histology was 530 clear cell (ccRCC), 257 papillary (pRCC), 100 chromophobe (cRCC), and 123 other. Individuals with pRCC compared to ccRCC were more likely to be NHB than NHW (OR 4.41; 95%CI 2.81,6.93) and more likely to have a higher Fuhrman grade (OR 1.5; 95%CI 1.03,2.07), but were less likely to be female (OR 0.50; 95%CI 0.35,0.72) or H than NHW (OR 0.518, 95%CI 0.271,0.991). Individuals with cRCC compared to ccRCC were also more likely to be NHB than NHW (OR 2.23, 95%CI 1.06,4.67) and to have higher Fuhrman grade (OR 1.82, 95%CI 1.06,3.14). Conclusions: In the MECC dataset, histology of RCC varies by race, confirming earlier reports that non-ccRCC is more common in NHB than NHW. We also report for the first time that pRCC is less common in H than NHW. These associations will be evaluated in additional larger national data sets and may help elucidate reasons for disparate RCC outcomes among various races and ethnicities.

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Sankari, Bashir R., and Shih-Chieh Jeff Chueh. "Simultaneous Laparoendoscopic Single-site Radical Nephrectomy for Native Kidney and Open Nonischemic Partial Nephrectomy to Treat Concomitant Renal Cell Carcinomas in Native and Transplant Kidneys and to Preserve Allograft Function." Urology 79, no. 1 (January 2012): 139–44. http://dx.doi.org/10.1016/j.urology.2011.09.015.

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32

Tadic, Jelena, Nemanja Rancic, Katarina Obrencevic, Milorad Radojevic, Predrag Maric, Aleksandar Tomic, and Marijana Petrovic. "Post nephrectomy renal function: Donor nephrectomy versus radical nephrectomy." Vojnosanitetski pregled, no. 00 (2021): 102. http://dx.doi.org/10.2298/vsp210419102t.

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Background/Aim. Monitoring the renal function following donor or radical nephrectomy due to kidney tumors is considered to be essential. The aim of this study was to compare pre-operative and post-operative renal function in patients who underwent donor nephrectomy in relation to patients who underwent radical nephrectomy due to renal malignancy. Methods. A retrospective case-control study was performed, which included 199 patients divided into two groups: Group 1 (105 patients) were patients who underwent donor nephrectomy due to living related/unrelated kidney transplantation, while group 2 (94 patients) was a control group and included patients who underwent radical nephrectomy due to clear cell renal cell carcinoma in the T1bNoM0 clinical stage, where this surgical procedure was the final form of treatment. Results. Pre-operative eGFR EPI in the donor group was 94.95 ml/min/1.73m2, while in the radical nephrectomy patient group it was 71.00 ml/min/1.73m2. Patients who underwent radical nephrectomy tended to have GFR below 60 ml/min/1.73m2 after ten years of follow-up compared with patients who underwent donor nephrectomy. In the donor nephrectomy group, the average GFR was 80.40 ml/min/1.73m2 and in the radical nephrectomy group it was 56.00 ml/min/1.73m2. A higher incidence of diabetes and hypertension was also observed in the donor nephrectomy group of patients compared to the radical nephrectomy group (HTA: 44.3% vs. 21.3%; diabetes: 22.6% vs. 9.6%, respectively). Conclusion. Comparative monitoring of these two groups showed that in both groups the recovery of renal reserve was achieved one year after nephrectomy, due to the known adaptive mechanisms. Regardless of the fact that with live transplantation in a kidney donor, we reduce the initial renal reserve (nephrectomy, permanent loss of renal mass), due to the adaptive mechanisms, kidney donors recover the kidney function within the first year after surgery.

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Gershman, Boris, R. Houston Thompson, Stephen A. Boorjian, Christine M. Lohse, Brian A. Costello, John C. Cheville, and Bradley C. Leibovich. "Radical Versus Partial Nephrectomy for cT1 Renal Cell Carcinoma." European Urology 74, no. 6 (December 2018): 825–32. http://dx.doi.org/10.1016/j.eururo.2018.08.028.

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34

Young, Shamar, Jafar Golzarian, and J. Kyle Anderson. "Thermal Ablation of T1a Renal Cell Carcinoma: The Clinical Evidence." Seminars in Interventional Radiology 36, no. 05 (December 2019): 367–73. http://dx.doi.org/10.1055/s-0039-1696650.

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AbstractRenal cell carcinoma (RCC) is most commonly diagnosed at an early (T1a) stage and is typically amenable to several effective treatments. The current gold standard therapy is partial nephrectomy, given its decreased morbidity and similar oncologic outcomes when compared with radical nephrectomy. Thermal ablation is an evolving definitive therapy for T1a RCC which is even less invasive than partial nephrectomy. This article reviews the evidence for thermal ablation in the treatment of T1a RCC and compares outcomes of existing ablation modalities with surgical management.

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Morshed, Md Selim, Hafiz Al-Asad, Mohammad Saruar Alam, Abu Naser Md Lutful Hasan, Md Towhid Belal, AKM Shahadat Hossain, and Sojib Bin Zaman. "OUTCOME OF STAGE T1 RENAL CELL CARCINOMA TREATED WITH PARTIAL NEPHRECTOMY: INITIAL EXPERIENCES FROM A TEACHING HOSPITAL IN BANGLADESH." Public Health of Indonesia 4, no. 3 (September 10, 2018): 91–99. http://dx.doi.org/10.36685/phi.v4i3.205.

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Background: Renal cell carcinoma accounts for 85% of all solid tumors of the kidney. For many years, radical nephrectomy was the standard treatment for RCC. Partial nephrectomy has gradually replaced radical nephrectomy over the past decade, especially for T1 stage renal cell carcinoma. However, the benefit of partial nephrectomy on oncologic outcomes is not well known.Objective: to investigate the clinical outcome of partial nephrectomy on T1 renal cell carcinoma. Methods: This prospective observational study was conducted in a single unit of urology department of Dhaka Medical College Hospital, Bangladesh from the period September 2014 to September 2017. Fourteen patients underwent partial nephrectomy during this period with renal mass based on eligibility criteria. Two follow up was done at three months and six months. Result: Mean age of the patients undergoing surgery was 52.0± 3.8 (46.0 to 57.0 years) years. For the majority of the patients, tumour size was in a range of 3-7 cm. Average operative time was 90 minutes and mean ischaemic time was 16.5 ± 4.6 minutes (14.5 to 21.0 minutes). Histopathological reports correlated with clinical diagnosis and showed adequate surgical clear margin in every case. There was no recurrence of tumour noticed during the two follow up periods. The different investigation did not reveal the impaired renal functional test during the follow-up period. Conclusion: The clinical outcome of partial nephrectomy was found better in this study. Partial nephrectomy has the potential to replace radical nephrectomy for managing T1 tumours. However, there are some controversies regarding the post-operative oncological outcome. More studies are recommended to investigate the effect of partial nephrectomy for T1 tumours.

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Lam, John S., John T. Leppert, Robert A. Figlin, and Arie S. Belldegrun. "Surveillance following radical or partial nephrectomy for renal cell carcinoma." Current Urology Reports 6, no. 1 (January 2005): 7–18. http://dx.doi.org/10.1007/s11934-005-0062-x.

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Acar, Ömer, and Öner Şanlı. "Surgical Management of Local Recurrences of Renal Cell Carcinoma." Surgery Research and Practice 2016 (2016): 1–6. http://dx.doi.org/10.1155/2016/2394942.

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Анотація:

Surgical resection either in the form of radical nephrectomy or in the form of partial nephrectomy represents the mainstay options in the treatment of kidney cancer. In most instances, resecting the tumor bearing kidney or the tumor itself provides durable cancer specific survival rates. However, recurrences may rarely develop in the renal fossa or remnant kidney. Despite its rarity, locally recurrent RCC is a challenging condition in terms of the possible management options and relatively poor prognosis. If technically feasible, wide surgical excision and ensuring negative surgical margins are the most effective treatment options. Repeat surgeries (completion nephrectomy, excision of locally recurrent tumor, or repeat partial nephrectomy) may often be complicated, and perioperative morbidity is a major concern. Open approach has been extensively applied in this context and 5-year cancer specific survival rates have been reported to be around 50%. The roles of minimally invasive surgical options (laparoscopic and robotic approach) and nonsurgical alternatives (cryoablation, radiofrequency ablation) have yet to be described. In selected patients, surgical resection may have to be complemented with (neo)adjuvant radiotherapy or medical treatment.

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Jang, Yun Hyung, Hanjong Ahn, and Choung-Soo Kim. "Renal Function after Partial Nephrectomy for Renal Cell Carcinoma in Solitary Kidney." Korean Journal of Urology 48, no. 12 (2007): 1213. http://dx.doi.org/10.4111/kju.2007.48.12.1213.

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39

Miller, David C., Mark S. Litwin, Julie Lai, and Christopher S. Saigal. "490: Renal Health Outcomes Following Radical or Partial Nephrectomy for Renal Cell Carcinoma." Journal of Urology 177, no. 4S (April 2007): 163–64. http://dx.doi.org/10.1016/s0022-5347(18)30730-4.

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Andrabi, Syed Aadil Shadaab, and Syed Mushtaq Ahmad Shah. "Bilateral renal cell carcinoma operated as right radical nephrectomy and left partial nephrectomy with histopathologically confirmed R0 resection." International Surgery Journal 7, no. 6 (May 26, 2020): 2043. http://dx.doi.org/10.18203/2349-2902.isj20202431.

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Bilateral renal tumors remain relatively uncommon, accounting for 1-5% of patients with renal cell carcinoma. Most sporadic renal cell carcinomas are unilateral and unifocal. Bilateral involvement can be synchronous or asynchronous and is found in 2-4% of sporadic renal cell carcinomas. We report a case of 70 years old male who was incidentally found to have bilateral renal masses. Right sided radical nephrectomy and left partial nephrectomy was performed. Histopathological examination of the specimen revealed clear cell carcinoma and confirmed R0 resection. The patient was discharged on 7th postoperative day.

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Cassell, Ayun Kotokai, Mohamed Jalloh, Bashir Yunusa, Medina Ndoye, Mouhamadou Mbodji, Abdourahmane Diallo, Saint Charles Kouka, Issa Labou, Lamine Niang, and Serigne M. Gueye. "Management of Renal Cell Carcinoma- Current Practice in Sub-Saharan Africa." Journal of Kidney Cancer and VHL 6, no. 2 (December 2, 2019): 1–9. http://dx.doi.org/10.15586/jkcvhl.2019.122.

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There is a global variation in the incidence of renal masses with the developed nations having a greater incidence. About 80–90% of renal malignancies are renal cell carcinomas (RCC) which account for 2–4% of all cancers. In Africa and the Middle East, the age-standardized incidence for RCC is 1.8–4.8/100,000 for males and 1.2–2.2/100,000 for females. The management of renal cell cancer is challenging. A multidisciplinary approach is effective for diagnosis, staging, and treatment. Guidelines recommend active surveillance, thermal ablation, partial nephrectomy, radical nephrectomy, cytoreductive nephrectomy and immunotherapy as various modalities for various stages of RCC. However, open radical nephrectomy is most widely adopted as an option for treatment at various stages of the disease in sub-Saharan Africa due to its cost-effectiveness, applicability at various stages, and the reduced cost of follow-up. Nevertheless, most patients in the region present with the disease in the advanced stage and despite surgery the prognosis is poor.

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42

Mannas, Miles, Ryan Flannigan, and Michael Eng. "Case ‒ Laparoscopic transperitoneal partial nephrectomy of T3a renal cell carcinoma within a horseshoe kidney." Canadian Urological Association Journal 12, no. 5 (February 2, 2018): E253–5. http://dx.doi.org/10.5489/cuaj.4781.

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Horseshoe kidney (HSK) is a benign malformation characterized by three anatomic abnormalities: ectopia, malrotation, and vascular changes.1 Renal cell carcinoma (RCC) comprises approximately 53.8% of HSK malignancies. The incidence of RCC within HSK is predicted to equal that within the general population, approximately 5.2/100 000 individuals.2-4 Surgical resection of these tumors has been described in the literature. Evidence is mounting that partial nephrectomy, rather than radical nephrectomy, and minimally invasive techniques for T3a RCC is safe and attains equivalent oncologic outcomes.5,6 Review of the literature reveals no case reports of laparoscopic partial nephrectomy for T3a RCC, and therefore, this is the first report of a laparoscopic partial nephrectomy of T3a RCC HSK with renal vein tumour thrombus.

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Kim, Jong Min, Phil Hyun Song, Hyun Tae Kim, and Tong Choon Park. "Comparison of Partial and Radical Nephrectomy for pT1b Renal Cell Carcinoma." Korean Journal of Urology 51, no. 9 (2010): 596. http://dx.doi.org/10.4111/kju.2010.51.9.596.

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44

Yang, Chao, and Zhaolin Liao. "Comparison of Radical Nephrectomy and Partial Nephrectomy for T1 Renal Cell Carcinoma: A Meta-Analysis." Urologia Internationalis 101, no. 2 (2018): 175–83. http://dx.doi.org/10.1159/000490576.

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Guttilla, Andrea, Alessandro Crestani, Fabio Zattoni, Silvia Secco, Fabrizio Dal Moro, Claudio Valotto, and Filiberto Zattoni. "Combined Robotic-Assisted Retroperitoneoscopic Partial Nephrectomy and Extraperitoneal Prostatectomy. First Case Reported." Urologia Journal 79, no. 1 (June 12, 2011): 62–64. http://dx.doi.org/10.5301/ru.2011.8884.

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A 54-year-old man with a history of prostate cancer and clear cell renal cell carcinoma of the left kidney underwent concomitant robot-assisted laparoscopic partial nephrectomy and radical prostatectomy. We report, to our knowledge, the first case of a concomitant retroperitoneal robotic-assisted partial nephrectomy and extraperitoneal radical prostatectomy.

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Milovic, Novak, Miodrag Lazic, Predrag Aleksic, Dragan Radovanovic, Vladimir Bancevic, Slavisa Savic, Dusica Stamenkovic, et al. "Rare locations of metastastatic renal cell carcinoma: Presentation of three cases." Vojnosanitetski pregled 70, no. 9 (2013): 881–86. http://dx.doi.org/10.2298/vsp120515014m.

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Introduction. Metastatic renal cell carcinoma (RCC) frequently spreads not only to neighboring lymph nodes, but also to distant organs, including the lungs, liver, bones and brain. Case report. We presented three cases of RCC with colon metastasis. In the first, 63-year-old patient, after left nephrectomy followed with lyphadenectomy in paraaortic lymph node, left hemicolectomy was done due to RCC metastasis in rectosigmoid colon. In the second, 35-year-old patient, left radical nephrectomy was followed two years later with partial right nephrectomy, lung metastasectomy, small bowel and coecum resection and right orchiectomy all as separate procedures in different time intervals. The patient died from brain and bone metastases two years after the first surgery. The third, 35-year-old patient, had right nephrectomy followed by repeted lymphadenectomies after 6, 12 and 24 months. Four years later RCC spreaded to coecum and right hemicolectomy was performed. Conclusion. RCC treated with nephrectomy should be carefully followed up with imaging methods as a proper treatment of RCC metastases to distant organs could be important for a patient survival.

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Zhang, Peng, and Jae Y. Ro. "Renal cell carcinoma." annals of urologic oncology 1, no. 1 (November 15, 2018): 1–18. http://dx.doi.org/10.32948/auo.2018.11.1.

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Анотація:

The global incidence of cases of kidney cancer has increased rapidly, and a relatively high incidence of kidney cancer has been reported in developed countries such as Northern and Eastern Europe. Various factors can affect the incidence and mortality of kidney cancer, including demographic risk factors, lifestyle factors, iatrogenic risk factors, nutritional factors and diet, occupation, and genetic factors. Renal cell carcinoma (RCC) refers to a tumor group with heterogeneity derived from renal tubular cells, which form almost all kidney cancer types. Clear cell RCC (ccRCC) is the most frequent renal tumor subtype, accounting for 75% of renal cancer, followed by papillar RCC(pRCC) making up approximately 10% of RCC. Hematoxylin-eosin staining shows a clear, eosinophilic cytoplasm in ccRCC cells. Epithelial cells forming the papillae and tubules have pRCC histological characteristics. Traditionally, genetic mutations of VHL and MET are the genetic features in ccRCC and pRCC, respectively. Recently, a new concept supports the contribution of mutations in some chromatin-modifier genes, including polybromo 1 (PBRM1), SET domain containing 2 (SETD2), BRCA1-associated protein-1 (BAP1), and lysine (K)-specific demethylase 5C (KDM5C). The metabolic disease concept in renal cancer is noted by researchers worldwide. The PD-1 pathway has been valued by researchers of kidney cancer in recent years, and new agents, such as anti-PD-1 monoclonal antibodies (nivolumab and pembrolizumab) and CTLA4 inhibitors (Ipilimumab), have been approved to treat advanced RCC. Partial nephrectomy (PN) and radical nephrectomy (RN) remain the standard management option for local RCC with a stage of T1 and T2, respectively. PN can also be selected for T2 stage RCC in suitable cases. Even though targeted therapy consisting of mainly the anti-VEGF and anti-mTOR pathways is recommended as the first-line and second-line treatment for RCC, the effectiveness and side effect of these therapies should be improved in future research.

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Leopold, Zev, Arnav Srivastava, and Eric A. Singer. "Predictors of Recurrence for T3a RCC: A Recurring Conundrum." Diagnostics 10, no. 11 (November 21, 2020): 983. http://dx.doi.org/10.3390/diagnostics10110983.

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Although the gold standard treatment for localized renal cell carcinoma (RCC) is radical nephrectomy (RN) or partial nephrectomy (PN), recurrence rates remain high at 7%, 26%, and 39% for T1, T2, and T3 staged disease, respectively [...]

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Nayak, Jasmir Gopal, Joshua Koulack, and Thomas Brian McGregor. "Laparoscopic Nephrectomy,Ex VivoPartial Nephrectomy, and Autotransplantation for the Treatment of Complex Renal Masses." Case Reports in Urology 2014 (2014): 1–4. http://dx.doi.org/10.1155/2014/354104.

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In the contemporary era of minimally invasive surgery, very few T1/T2 renal lesions are not amenable to nephron-sparing surgery. However, centrally located lesions continue to pose a clinical dilemma. We sought to describe our local experience with three cases of laparoscopic nephrectomy,ex vivopartial nephrectomy, and autotransplantation. Laparoscopic donor nephrectomy was performed followed by immediate renal cooling and perfusion with isotonic solution. Back-table partial nephrectomy, renorrhaphy, and autotransplantation were then performed. Mean warm ischemia (WIT) and cold ischemic times (CIT) were 2 and 39 minutes, respectively. Average blood loss was 267 mL. All patients preserved their renal function postoperatively. Final pathology confirmed pT1, clear cell renal cell carcinoma with negative margins in all. All are disease free at up to 39 months follow-up with stable renal function. In conclusion, the described approach remains a viable option for the treatment of complex renal masses preserving oncological control and renal function.

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Ohtake, Shinji, Takashi Kawahara, Go Noguchi, Noboru Nakaigawa, Kimio Chiba, Hiroji Uemura, Masahiro Yao, and Kazuhide Makiyama. "Renal Cell Carcinoma in a Horseshoe Kidney Treated with Laparoscopic Partial Nephrectomy." Case Reports in Oncological Medicine 2018 (June 7, 2018): 1–3. http://dx.doi.org/10.1155/2018/7135180.

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Introduction. Horseshoe kidney is one of the most common congenital renal fusion anomalies. Due to its poor mobility and abnormal vasculature form, surgeons should pay close attention to all anatomical variations. Case Presentation. An 83-year-old woman was referred to our hospital because of left renal tumor in a horseshoe kidney incidentally found by her previous hospital. We performed laparoscopic partial nephrectomy. The pathological diagnosis was clear cell renal cell carcinoma. G2 INFα V-pT1a with a negative surgical margin. No evidence of recurrence has been noted, and the renal function is well preserved at 28 months after surgery. Conclusion. When performing laparoscopic partial nephrectomy for renal carcinoma, especially a horseshoe kidney, preoperative imaging is crucial for identifying the location of the renal vessels.

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