The surgical approach

Arnaud Méjean and Marc-Oliver Timsit

in Renal Cancer

Published on behalf of Oxford University Press

ISBN: 9780199562312
Published online September 2011 | e-ISBN: 9780199607402 | DOI:

Series: Oxford Oncology Library

The surgical approach

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• Nowadays, in industrialized countries, approximately 70% of renal cancers are incidentally diagnosed on imaging • Contrast medium-enhanced computed tomography (CT) scans with early and late sequences are mandatory to answer numerous questions before surgery, and to define the approach and feasibility of nephron-sparing surgery • Tumour biopsy is not routinely performed • Partial nephrectomy is the standard of care for tumours <4cm, even with a normal contralateral kidney • Frozen sections are only necessary when surgical margins are macroscopically suspicious • Partial nephrectomy can be considered for tumours up to 7cm • Laparoscopic approach is the standard of care for radical nephrectomy, whereas it remains an option for partial nephrectomy because of higher morbidity and technical difficulty • The need for radical nephrectomy for metastatic disease remains to be determined for patients receiving targeted anti-angiogenic therapies • Ablative mini-invasive techniques (cryoablation and radiofrequency ablation [RFA]) obtain satisfactory cancer control only in limited indications.

Chapter.  2499 words.  Illustrated.

Subjects: Clinical Oncology

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