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Experience of the parenchyma saving procedure in the surgical management of renal cell carcinoma
Authors:M Togashi  T Mori  S Nagamori  B Saitoh  H Morita  T Seki  T Gotoh  K Nonomura  T Koyanagi
Abstract:The result of renal conserving procedures for the surgical management of renal cell carcinoma experienced in 10 patients was reported. All except two were afflicted with tumor involvement in both kidneys (four cases) or in the solitary functioning kidney (four cases). The tumor stage was I in 8 and IV in 2 patients. One of the stage IV patients died of metastatic disease 8 months postoperatively. Of the 9 patients, 8 remained free of cancer in the follow-up period, while one who received an enucleative surgery and whose pseudocapsule of the tumor was missing had a local recurrence. Four of the 5 tumors having no pseudocapsule or having an invasion in the pseudocapsule were grade 2 or 3. The renal conserving surgery is believed to yield an excellent control in low grade and low stage tumors. Partial nephrectomy, rather than simple enucleation, remains to be a preferred surgical treatment in parenchyma-sparing operation, although the enucleative surgery may have a good indication for multiple and central encapsulated tumors.
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