Trends in the surgical management of localized renal masses
Article first published online: 28 MAY 2013
© 2013 BJU International
Volume 111, Issue 8, pages 1182–1183, June 2013
How to Cite
Bolton, D. M. (2013), Trends in the surgical management of localized renal masses. BJU International, 111: 1182–1183. doi: 10.1111/j.1464-410X.2012.11509.x
- Issue published online: 28 MAY 2013
- Article first published online: 28 MAY 2013
There has been repeated evidence providing support for the role of nephron-sparing surgery for smaller and surgically favourable renal lesions, with radical nephrectomy having been demonstrated to be an independent risk factor for the development of chronic renal failure and its complications . Patients with radical nephrectomy-induced chronic renal insufficiency have a 25% increased risk of cardiac death and a 17% increased risk of death from any cause compared to patients undergoing nephron preservation surgery for cT1b tumours .
Despite this evidence, data from the USA and Australia have indicated a continuing under-utilization of nephron-sparing surgery for small renal masses, with significant regional and institutional variation [3, 4]. The present study again brings to our attention the importance of viewing any renal mass in the overall context of the patient's expected longevity and associated medical morbidities, with the ultimate goal being cure from an early renal malignancy without compromising the future renal capability of an individual's nephron mass to ensure expected longevity. The message arising from this and other related publications should not be neglected.
- 4Overtreatment of small renal masses in Victoria – should we be concerned? BJU Int 2012; 109 (Suppl. 4): 36, , et al.