ELECTIVE CONSERVATIVE SURGERY FOR RENAL-CARCINOMA VERSUS RADICAL NEPHRECTOMY - A PROSPECTIVE-STUDY

Objective To identify criteria with which to select candidates for con servative nephrectomy, and to compare the results of radical and conse rvative nephrectomy in two homogeneous groups of patients with renal c arcinoma, in a prospective study. Patients and methods Forty patients (27 men and 13 women, mean age 49.9 years, range 23-76) with renal car cinoma (T1-T2 NOMO, <4 cm in diameter) were enrolled in the study betw een 1988 and 1993 and followed for a maximum of 98 months (mean 70.1), The patients were divided into two groups: Group A comprised 19 patie nts (mean age 51.4, so 13.7 years, mean tumour size 3.34, SD 0.64 cm) who underwent partial nephrectomy; Group B comprised 21 patients (mean age 45.7, SD 14.7 pears, mean tumour size 3.21, SD 0.56 cm) who were selected for radical nephrectomy, The survival and progression of dise ase were assessed. Results Survival did not differ between the groups; one patient from each group died from distant metastases, There were no cases of local recurrence and multifocal neoplastic lesions were fo und in one patient during surgery, Conclusion This prospective study c onfirms the results of retrospective studies that conservative surgery is as effective as radical surgery for renal carcinoma; however, its clinical application is limited by the risk that the renal carcinoma i s multifocal.