RADICAL NEPHRECTOMY IS STILL PREFERABLE IN THE TREATMENT OF LOCALIZEDRENAL-CELL CARCINOMA - A LONG-TERM FOLLOW-UP-STUDY

Objectives: Due to the advances of radiological methods, an increased number of incidentally detected renal cell carcinomas is diagnosed. Th e reported excellent results of nephron-sparing surgery have promoted its application in patients with a normal contralateral kidney. Howeve r, the risk of local tumor recurrence and surgical complications after nephron-sparing surgery might be higher compared with radical nephrec tomy. Methods: In 89 patients with localized renal cell carcinoma trea ted with radical nephrectomy, long-term renal function, morbidity, and survival were evaluated. The renal function was followed up regularly with serum creatinine measurements. Results: The cause-specific 5-yea r survival rate was 91.6 %. There was neither local nor contralateral kidney tumor recurrence in any patient. Surgical complications were ob served in 3 % of the patients. Mean serum creatinine after the nephrec tomy was 123 mu mol/l without further increase during 10 years of foll ow-up. Conclusions: Radical nephrectomy of localized renal cell carcin oma has low morbidity, excellent local tumor control, and a high survi val rate. For patients with a normally functioning contralateral kidne y the long-term renal function remained adequate. Based on these data, there is no convincing evidence justifying nephron-sparing surgery to be used routinely for patients with a normally functioning contralate ral kidney.