Kidney cancer, also known as renal cell carcinoma, has a high incidence at the age of 40 to 65, and is more common in men than women. Kidney cancer is not a rare tumor, and its incidence rate has been increasing year by year in recent years, and now it ranks among the top ten tumor incidence rates in China. The early symptoms of kidney cancer are not obvious, and nearly 30% of the patients are already in advanced stage when they are discovered, missing the best time for treatment. Question 1: What should I do if I have kidney cancer? Up to now, surgery is still the most effective and basic method to treat kidney cancer. Even for patients with metastatic kidney cancer, we should strive to remove the affected kidney to reduce the tumor load and improve the efficacy of other treatments. After surgery, biological immune support therapy can be given according to the patient’s actual condition; kidney cancer is not very sensitive to radiotherapy and chemotherapy, so it is generally not recommended; when advanced kidney cancer can no longer be resected, interventional therapy can be used to reduce the size of the tumor. In the past, the surgical treatment for kidney cancer was mainly radical nephrectomy, which included the kidney, perirenal fat, fascia, upper ureter and lymph nodes of the kidney tip. However, in recent years, kidney cancer surgery with preservation of kidney unit has been more and more recognized and accepted by more and more doctors and patients for smaller tumors internationally. Question 2: What is renal unit preserving surgery? Renal unit preserving surgery is a general term for surgery that preserves the kidney, including partial nephrectomy, wedge nephrectomy and renal tumor enucleation. It is similar to when we peel an apple, we cut out all the rotten areas and keep the good flesh, the principle is similar. Question 3: Pros and cons of preserving kidney The kidney is an important organ in the human body, playing an important role in urine production, metabolism and red blood cell renewal. Nephrectomy with preservation of kidney units can completely remove the tumor lesion while maximizing the preservation of normal renal parenchymal units, which adds a guarantee for the patient’s future healthy life. Haphazard removal of the kidney often results in serious impact on kidney function. Once the problem occurs again in the contralateral kidney in the future, there will be no more options for treatment. Especially for patients with isolated kidney cancer, double kidney cancer, kidney cancer on one side with severe renal insufficiency, and kidney cancer on one side with contralateral renal failure, or patients with chronic kidney disease tendency, preserving kidney unit surgery is extremely important to effectively avoid the occurrence of renal insufficiency and uremia in the future. Question 4: Is kidney preservation available for all kidney cancers? Although kidney preservation surgery has many benefits, not every kidney cancer patient is able to preserve the kidney. This surgery is generally suitable for kidney tumors that are less than 4 cm in diameter and confined to the edge or upper and lower poles of the kidney. For kidney cancer patients with isolated kidney tumors that are large and close to the central part of the kidney, if conditions permit, isolated bench surgery can be performed to remove the tumor followed by autologous kidney transplantation. It should be said that kidney preservation surgery is technically demanding and has very strict surgical indications, and its most important premise is that tumor removal should meet the requirements of tumor surgery. Therefore, the decision of whether to save kidney or not after kidney cancer must be made carefully by experienced surgeons, who will follow up closely after the operation. Question 5: Is the success rate of kidney preservation surgery high? Successful kidney unit preservation surgery has essentially similar 5-year cancer-related survival rates compared to traditional radical kidney cancer surgery, yet it can preserve more kidney function while effectively controlling the tumor. In addition, patients recover faster and bleed less after kidney preservation surgery, and all kinds of postoperative complications such as renal insufficiency and proteinuria are significantly reduced, which significantly improves patients’ quality of life and has now replaced a significant portion of radical nephrectomy surgery. At present, patients undergoing kidney-conserving surgery in our urology department have accounted for more than 30% of all kidney cancer surgeries, and the success rate of the surgery is maintained at more than 95%.