Which kidney cancer patients can choose nephron-sparing surgery

The first choice for the treatment of localized and locally advanced renal cancer is undoubtedly surgery. For patients with residual tumors after surgery, immunotherapy or chemotherapy or (and) radiotherapy based on immunotherapy or difluorodeoxycytidine can be used. Whether the kidney can be preserved is one of the most concerned issues for patients with renal cancer during surgical treatment.

Nephron-sparing surgery (NSS) has the same efficacy as radical nephrectomy. NSS can be performed through open surgery or laparoscopic surgery. The local recurrence rate after nephron-sparing surgery is 0%~10%, while the local recurrence rate after renal cancer with a tumor ≤4cm is 0%~3%. Patients need to make a choice based on the progression of their own disease and the various indications of NSS, but they need to understand the potential risk of recurrence after the surgery before surgery. The mortality rate of NSS is 1%~2%.

NSS indications: Renal cancer occurs in anatomically or functionally solitary kidney, and radical nephrectomy will lead to renal insufficiency or uremia

Relative indications of NSS: patients with certain benign diseases in the contralateral kidney of renal cancer, such as kidney stones, chronic pyelonephritis or other diseases that may cause deterioration of renal function (such as hypertension, diabetes, renal artery stenosis, etc.).

NSS is an option for patients with clinical stage T1a (tumor ≤ 4 cm), tumors located around the kidney, single asymptomatic renal cancer, and normal contralateral renal function.

It should be noted that NSS indications and relative indications have no specific limitations on tumor size.