Limited renal cell carcinoma refers to renal cell carcinoma with tumor confined to the peritoneum of the kidney, including TNM stage T1-2N0M0 and clinical stage I and II. With the improvement of imaging technology and the popularity of health screening, the proportion of confined renal cell carcinoma has exceeded 50 . A growing number of studies have shown that partial nephrectomy has similar oncologic outcomes and better renal function protection than RN in most stage T1, some stage T2, and even some stage T3a renal cell carcinomas.
For patients with stage T1a renal cell carcinoma, NSS is recommended as far as technically possible, while RN is recommended for patients with complex anatomy who are difficult to perform partial nephrectomy and have normal contralateral renal function. For patients with stage T1b renal cell carcinoma, NSS or RN is recommended, and the complexity of the tumor, such as its size, location, depth, and individual patient differences, still need to be considered in the selection of the surgical approach. NSS can also be chosen for some appropriate patients with stage T2 renal cell carcinoma who otherwise receive RN.
Postoperative adjuvant therapy: Adjuvant radiotherapy, chemotherapy, immunotherapy and targeted therapy after surgery for limited renal cell carcinoma cannot reduce the recurrence rate and metastasis rate of the tumor. Therefore, postoperative patients with stage T1 to 2N0M0 renal cell carcinoma are mainly observed in follow-up and can participate in clinical trials without the routine use of adjuvant therapy.