Long-Term Results of Nephron Sparing Surgery for Localized Renal Cell Carcinoma

Abstract

Several unrandomized studies from the current literature confirm that in selected patients with localized renal cell carcinoma (RCC), nephron sparing surgery (NSS) shows to be as effective as radical surgery. In this regard, we evaluated the data from patients treated by using such a conservative approach with a long-term follow-up. Materials and Methods. We considered 28 patients (19 M, 9 F; median age 54 years) with unilateral, localized, small (< 4 cm) RCC, submitted to NSS from 1988 to 1994. Only 3 of them (10%) were symptomatic at presentation. Oncological follow-up had been conducted with visits every 4 months for the first two years, every six for another three years and then annually. Results. All the patients were clinical stage T1aN0M0 (UICC TNM 2002). Grading was: 10 G1, 10 G2, 8 G3. Mean tumor diameter was 3.2 cm. After a long-term follow-up (mean 10 years, range 8–14), none present local relapse, disease specific survival is 93% and overall survival is 86%. Based on biochemistry, 82% of the remaining patients still have a normal renal function. Conclusions. Given the excellent long-term results and the recognized benefits of elective NSS, this approach should be preferentially adopted in a selected population of patients with small (<4 cm), unilateral, RCC.