Why do patients with early stage (limited) kidney cancer need to receive surgery? For limited kidney cancer, surgery can bring most patients to the level of cure. The current surgical options are radical nephrectomy and partial resection with preservation of the kidney unit, and for most patients this can be done using minimally invasive techniques (laparoscopy) with results that are at the open level or even better than open surgery. The specific treatment depends on a number of factors, including the patient’s age, health status, risk of anesthesia, and tumor size, location, and infiltration. Usually the larger the tumor, the greater the likelihood of radical nephrectomy, unless the patient may experience decreased kidney function requiring dialysis after complete removal of the affected kidney, in which case as many normal kidney units as possible are preserved. However, the exact choice of surgery must be decided in consultation with the doctor according to the patient’s specific situation. What is radical nephrectomy? Radical nephrectomy includes open and laparoscopic radical nephrectomy. Open incisions can be made in the abdomen or in the lower back, but they are usually large, which is not only aesthetically unpleasant, but also more invasive and takes longer to heal. Laparoscopic nephrectomy avoids these shortcomings, and the surgeon can perform the surgery through a smaller access, except for patients with cancerous thrombosis, large tumors and large lymph nodes, in which case laparoscopic surgery can be considered. Over the past decade, laparoscopic surgery has evolved into the standard approach for radical nephrectomy, which is less invasive, has a rapid recovery, and has fewer contraindications to surgery. However, laparoscopic surgery requires an experienced and skilled surgeon to perform. What is partial nephrectomy? If the patient has a small tumor, or if removal of the affected kidney would severely affect renal function, it is necessary to consider whether to preserve the kidney unit for surgery. If the tumor is less than 175 px, it may be appropriate to undergo surgery to preserve the renal unit. With advances in medical technology, removal of the entire kidney is not necessary for many patients. By partial nephrectomy, we mean the removal of only the tumor and a small portion of normal kidney tissue at the edge of the tumor. As the understanding of renal tumors becomes clearer, it has been proven over the years that the tumor recurrence rate in patients who undergo partial nephrectomy is not higher than that in patients who undergo radical nephrectomy. With the accumulation of experience and the improvement of laparoscopic level, both open and laparoscopic partial nephrectomy has become a routine procedure. Why partial nephrectomy? For isolated kidney tumor or double kidney tumor, if radical nephrectomy is used, it will definitely lead to the patient to receive dialysis, so partial nephrectomy is necessary. If the patient has diabetes, hypertension, kidney stones, chronic infection, lupus nephritis and other diseases that are currently or may affect total kidney function in the future, removal of the affected kidney may result in a critical state of residual kidney function and the risk of dialysis in the future. In patients with normal renal function on both sides and no underlying disease, when preparing to remove one kidney, surgeons and patients must consider the possibility of postoperative renal insufficiency. Although one kidney has no impact on the patient’s future life, the more normal kidney tissue, the better, of course. Problems such as stones, infection, hypertension, diabetes, and aging can occur over time and may adversely affect kidney function. Therefore maximizing the preservation of normal kidney tissue is particularly beneficial for younger patients. In addition, for patients who have one kidney removed because of a tumor, the risk of reoccurrence of the tumor in the opposite kidney is higher than normal. Therefore, to some extent, partial nephrectomy has become a standard treatment option rather than just an elective one.