Can pregnant women with kidney cancer undergo surgery?

The traditional surgical method for treating kidney cancer is radical nephrectomy, which requires the removal of the entire kidney as well as the perirenal fat tissue and adrenal gland. For many years, radical nephrectomy has been considered the standard surgical procedure for treating kidney cancer. Nephrone-sparing surgery (NSS) is a revolutionary advancement in kidney surgery, so can pregnant women with kidney cancer undergo surgery?

Renal cancer does not have a true histological capsule, but often has a pseudocapsule composed of compressed renal parenchyma and fibrous tissue. Usually, surgeons use the pseudocapsule as a landmark to determine the scope of surgical resection. The traditionally used NSS surgical margin is the renal parenchyma within a range of more than 10 mm outside the pseudocapsule. A 10 mm surgical margin is certainly safe, but it may also result in the loss of many functional renal units. There is currently a lot of controversy about the scope of the margin. In recent years, many studies have shown that a 5 mm surgical margin can achieve the same therapeutic effect and will not increase the recurrence rate. Some scholars even believe that extracapsular resection (i.e., a 0 mm margin) is also safe enough. In response to this hot issue, our Department of Urological Oncology has conducted special scientific research, and the preliminary conclusion is that, in general, a 4 mm margin should be used to ensure safe resection of the tumor. In addition to the size and location of the tumor, the tumor margin range should be determined in combination with factors such as the integrity of the pseudocapsule and the malignancy estimated by imaging examinations such as CT, and an individualized margin range should be selected.
It is generally believed that NSS has more complications than radical nephrectomy. The main complications are bleeding, urine leakage, acute renal function decline, etc. However, with the advancement of surgical techniques and the update of instruments and hemostatic materials, NSS has become a relatively safe operation. No serious complications occurred in the NSS we performed, and no recurrence has occurred in the follow-up so far, achieving good treatment results.