Validity of kidney-preserving surgery for localized renal cell carcinoma.

Abstract

A study was performed to evaluate whether kidney-preserving surgery would be appropriate or not, and in the affirmative for which indications. Eighty-one kidneys removed at Seoul National University Hospital between January 1987 and June 1991 were serially cut into 5-mm slices to probe for any small renal lesions. Of the 81 kidneys, 15 (18.5%) renal units contained 39 satellite nodules with histological patterns identical to the primary tumor. The number of satellite nodules was 2.6 per kidney (range 1-6). The size of the satellite nodules ranged from 0.5 to 2 cm (mean 0.9 cm). The presence of satellite nodules increased with increasing T stage and size of the primary tumor (p < 0.05 by Fisher's exact test). The presence of satellite nodules was significantly different between kidneys with primary tumors larger than 7 cm and less than 7 cm (p < 0.05 by the chi 2 test). Especially, no satellite nodules were found in 23 kidneys whose primary tumors were less than 5 cm. These observations suggest that kidney-preserving surgery could be a valuable treatment option for small localized renal cell carcinoma not only in patients with a single kidney or deteriorated contralateral kidney function but also in patients with normal contralateral kidneys, especially when the size of the tumor is less than 5 cm.