RENAL PARENCHYMA-SPARING SURGERY AS CONSERVATIVE TREATMENT OF RENAL-CELL CARCINOMA

Objective To evaluate the role of parenchyma-sparing surgery in patien ts with renal cell carcinoma (RCC). Patients and methods Between 1965 and 1990, 34 patients with RCC underwent renal parenchyma-sparing surg ery. There were 22 men and 12 women with a mean age of 62 years (range 40-89). Ten patients underwent enucleation (Group A), 15 partial neph rectomy (Group B), and nine a combination of procedures (Group C). Con servative surgery was performed in the presence of a normal contralate ral unit in four patients (12%). Results Five patients developed local recurrence. Metastases appeared in six patients (18%) from 12 to 58 m onths post-operatively. Adequate renal function was obtained in 32 of the 34 patients. The mean follow-up for all patients was 64.6 months o verall, 75.6 months for group A, 64.1 months for group B and 53.4 mont hs for group C. The 3 and 5 year probabilities of survival for all pat ients were 77.8% and 69.5% respectively. The probabilities of 3 and 5 year survival were 80% for group A, 80% for group B and 71.4% and 57.1 % for group C. Conclusion Enucleation and partial nephrectomy are both viable options in the management of solitary or bilateral RCC, as the re is no decline in effective tumour control and prognosis. Larger gro ups and longer follow-ups are needed to assess the role of renal paren chyma-sparing surgery more definitively.