Partial resection or radical surgery for limited renal cancer

The incidence of kidney cancer has been increasing in China in recent years, mainly due to clear cell carcinoma, the cause of which is still unclear. Nowadays, the three typical symptoms of kidney cancer “hematuria, lumbar pain and lumbar mass” are less and less common among patients, and only a small number of patients will see them. At present, there are still controversies about the surgical treatment of kidney cancer, especially for the kidney with tumor growth, whether to choose partial resection? Or radical resection is also a question that makes many patients hesitate. Traditionally, partial nephrectomy was performed when the patient had only one kidney. Nowadays, the indications for surgery are being relaxed. Du Peng, Department of Urology, Peking University Cancer Hospital, has now performed hundreds of partial nephrectomies in our department, mainly for the effects of single central renal tumor, not close to the major arteries and veins of the kidney, renal tumor invading the renal pelvis should not be too deep, patient’s age, cardiovascular condition, etc. The surgical results are clear, and the patient has good kidney function in the postoperative follow-up, and no clear recurrence cases have been seen. In the preoperative communication with patients, I found that most patients were most worried about whether the remaining kidney would recur tumor after surgery, so they hesitated between radical kidney resection and partial nephrectomy. In fact, during partial nephrectomy, the kidney tumor is removed along 2 cm within the normal kidney tissue around the tumor, and according to the intraoperative or postoperative pathology, the clean removal of kidney tumor can be guaranteed. And for multicentric renal cancer, we usually recommend radical renal resection. Compared with traditional radical nephrectomy, partial nephrectomy on the one hand can preserve the affected kidney and reduce the risk of long-term dialysis if the opposite kidney develops lesions, and at the same time, it is less traumatic to remove the specimen after laparoscopic surgery than radical surgery, so for eligible kidney cancer patients, partial nephrectomy has become a trend of surgery today. I am now fully open, so if patients have any questions, they can consult me on the website. I will try my best to give you answers.