Partial Nephrectomy is the Surgical Treatment of Choice for (Most) Complex Localized Renal Tumors

Abstract

The decision to undergo partial nephrectomy (PN) versus radical nephrectomy (RN) for a localized renal mass should take various factors into consideration, including tumor characteristics, patient’s health status and preference, and risks and benefits of these each approach. PN represents a suitable surgical approach for small renal tumors in favorable locations. It may also better preserve long-term renal function, particularly in patients who may need surgery for a contralateral kidney mass or have preexisting chronic kidney disease. Conversely, RN may be preferred in elderly patients with severe (non-renal related) comorbidities, in patients with an anatomically challenging tumor location, or for larger or locally advanced masses. The presentation and management of renal tumors has changed substantially during the last few decades. The increasing use and quality of crosssectional imaging has been associated with increased incidence, earlier detection and improved staging of renal masses [12]. Most kidney tumors are now diagnosed incidentally in asymptomatic patients [3]. In a recent study by Welch et al. examining a large cohort of Medicare beneficiaries, increase rates of computed tomography (CT) imaging was associated with