Open Surgery for Localized RCCReportar como inadecuado

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TheScientificWorldJOURNAL - Volume 7 2007, Pages 742-752

Review Article Department of Urology, University Hospitals Leuven, Belgium

Received 17 October 2006; Accepted 27 December 2006

Academic Editor: Ziya Kirkali

Copyright © 2007 Kathy Vander Eeckt et al.


The only possibility for cure in localized renal cell carcinoma RCC is surgery. Open radical nephrectomy RN, as described by Robson, has long been the gold standard. Nevertheless, as a consequence of the increased use of abdominal imaging modalities, a continuing stage migration towards small, low-grade RCC lesions has become evident during the last decades. Together with this stage migration, nephron-sparing surgery NSS, less-invasive therapies laparoscopic RN and NSS, and minimally invasive therapies radiofrequency ablation RFA, cryoablation have been developed and are gaining popularity. The value of laparoscopic RN and open NSS are acknowledged worldwide, but the value of laparoscopic NSS, RFA, and cryoablation remains to be established. Despite this evolution, there is still a place for open surgery for localized RCC. Open NSS is, at present, considered the standard of care for localized RCC less than 4 cm, while open RN still has a place for larger lesions, certainly when an extended lymph node dissection or adrenalectomy is warranted, or when a tumor thrombus is extending into the inferior vena cava. This review provides the data that support open surgery in clear, selected cases of RCC.

Autor: Kathy Vander Eeckt, Steven Joniau, and Hein Van Poppel



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