PARTIAL RENAL RESECTION IN RENAL-CELL CARCINOMA

In 18 patients with renal cell carcinoma in anatomical or functional s ingle kidneys, with limited renal function or bilateral tumors, partia l renal resection was absolutely indicated to preserve renal function. In 17 patients with small peripheral tumors and intact contralateral kidney, partial renal resection was performed electively. One patient of each group died during postoperative care. During follow-up, 4 pati ents with absolute indication for partial renal resection showed progr ession of the disease. Three developed distant metastases, and in one patient local relapse with infiltration of the inferior cava vein occu rred. These 4 patients had had a bilateral synchronous or asynchronous stage pT2 or pT3 renal cell carcinoma and died from the neoplasm with in 10-36 months postoperatively. 13 of 18 patients with absolute indic ation remained tumorfree during a median follow-up period of 57 months . Partial renal resection saved 15 of these 17 patients from dialysis. Sixteen of 17 patients in whom partial renal resection was performed electively remained tumorfree during a median follow-up period of 28 m onths. The results suggest that, given an absolute indication to preve nt dialysis, partial renal resection should be performed whenever tech nically possible. In patients with small peripherally located tumors a nd intact contralateral kidney, partial renal resection as an elective procedure must be considered a genuine alternative to radical nephrec tomy.