H Wunderlich, et al (Freidrich Schiller Univ, Jena Germany)
Nephron Sparing Surgery for Renal Cell Carcinoma 4cm or less in diameter: Indicated or Under Treated ?
Urol 159: 1465-1469, 1998
Background : Radical Nephrectomy continues to be the standard treatment for localised unilateral renal cell carcinoma in patients with normal contralateral kidneys.
The use of radical nephrectomy was retrospectively studied with respect to size and metastasis of renal cell carcinoma.Findings: The frequency of grade I renal cell carcinomas declined with increasing tumor diameter.The opposite was noted for grade 3. Tumor size was associated with lymph node and distant metastasis.Frequency of venous involvement increased along with increase in tumor size.Conclusion : The metastatic potential and biology of small renal cell carcinomas have not been established.
To minimise the risk of recurrence Nephron sparing surgery might be limited to those with renal cell carcinomas of 20mm or less.