1307: Renal Radiosurgery and Sorafenib as Non-Invasive Nephron-Sparing Treatment of Small Localized Renal Masses

2007 ◽  
Vol 177 (4S) ◽  
pp. 430-430
Author(s):  
Ram Ganapathi ◽  
Troy R. Gianduzzo ◽  
Arul Mahadevan ◽  
Monish Aron ◽  
Lee E. Ponsky ◽  
...  
Keyword(s):  
Renal Masses ◽  
Non Invasive ◽  
Nephron Sparing

Functional and oncological outcomes of open nephron-sparing surgery for complex renal masses

2015 ◽  
Vol 33 (10) ◽  
pp. 427.e11-427.e16 ◽  
Author(s):  
Zaher Bahouth ◽  
Sarel Halachmi ◽  
Itamar Getzler ◽  
Orna Caspin ◽  
Boaz Moskovitz ◽  
...  
Keyword(s):  
Nephron Sparing Surgery ◽  
Renal Masses ◽  
Oncological Outcomes ◽  
Nephron Sparing

scholarly journals Oncological outcomes of partial nephrectomy for tumours larger than 4 cm: A systematic review

2014 ◽  
Vol 8 (1-2) ◽  
pp. 61 ◽  
Author(s):  
Tarek H El-Ghazaly ◽  
Ross J Mason ◽  
Ricardo A Rendon
Keyword(s):  
Systematic Review ◽  
Partial Nephrectomy ◽  
Survival Rates ◽  
Cancer Specific Survival ◽  
Renal Masses ◽  
Oncological Outcomes ◽  
Medical Associations ◽  
Nephron Sparing ◽  
Pubmed Search ◽  
Exact Size

Introduction: Many medical associations recommend nephron-sparing surgery (NSS) for tumours larger than 4 cm amenable to partial nephrectomy (PN). These recommendations are, however, mostly based on isolated reports. We systematically review the oncological outcomes of partial nephrectomy procedures performed for tumours larger than 4-cm.Methods: A PubMed search was carried out using keywords “partial nephrectomy” and “nephron sparing” for records dating back to 1995. In total, 2136 abstracts were analyzed; from these, 174 studies were scrutinized. We identified 32 manuscripts reporting size-specific cancer-specific survival rates for masses greater than 4 cm. From each of these studies, we recorded the number of PN, tumour diameter, follow-up duration, 5- and 10-year recurrence, overall and cancer-specific survival rates (OS, CSS). We also calculated weighted OS and CSS rates.Results: This systematic review includes 2445 patients with renal tumours larger than 4 cm who underwent PN: 1858 patients with tumours between 4 to 7 cm, 410 patients with tumours larger than 7 cm and 177 patients with tumours greater than 4 cm (exact size unknown). Our analysis revealed weighted 5-year CSS rates of 95.4%, 86.2% and 93.9% for tumours 4 to 7 cm, >7 cm, and all tumours >4 cm, respectively. The respective 5-year OS rates were 84.7%, 76.4%, and 84.7%.Conclusions: We found excellent 5-year CSS and OS rates for patients with tumours 4 to 7 cm treated with PN. These outcomes compare favourably to those reported in historical radical nephrectomy (RN) series for similarly sized tumours. Thus, PN is an acceptable and often preferred treatment for renal masses >4 cm which are amenable to nephron-sparing procedures.

scholarly journals Intraoperative ultrasound in robot-assisted partial nephrectomy: State of the art

2018 ◽  
Vol 90 (3) ◽  
pp. 195-198 ◽  
Author(s):  
Giacomo Di Cosmo ◽  
Enrica Verzotti ◽  
Tommaso Silvestri ◽  
Andrea Lissiani ◽  
Roberto Knez ◽  
...  
Keyword(s):  
Partial Nephrectomy ◽  
State Of The Art ◽  
Short Review ◽  
Robot Assisted ◽  
Small Renal Masses ◽  
Renal Masses ◽  
Ischemia Time ◽  
Oncological Safety ◽  
Nephron Sparing ◽  
Operative Ultrasound

Introduction: Nephron-sparing surgery (NSS) is of one of the most studied fields in urology due to the balancing between renal function preservation and oncological safety of the procedure. Aim of this short review is to report the state of the art of intra-operative ultrasound as an operative tool to improve localization of small renal masses partially or completely endophytic during robotassisted partial nephrectomy (RAPN). Material and methods: We performed a literature review by electronic database on Pubmed about the use of intra-operative US in RAPN to evaluate the usefulness and the feasibility of this procedure. Results: Several studies analyzed the use of different US probes during RAPN. Among them some focused on using contrastenhanced ultra sonography (CEUS) for improving the dynamic evaluation of microvascular structure allowing the reduction of ischemia time (IT). We reported that nowaday the use of intraoperative US during RAPN could be helpful to improve the preservation of renal tissue without compromising oncological safety. Moreover, during RAPN there is no need for assistant to hand the US probe increasing surgeon autonomy. Conclusions: The use of a robotic ultrasound probe during partial nephrectomy allows the surgeon to optimize tumor identification with maximal autonomy, and to benefit from the precision and articulation of the robotic instrument during this key step of the partial nephrectomy procedure. Moreover US could be useful to reduce ischemia time (IT). The advantages of nephron-sparing surgery over radical nephrectomy is well established with a pool of data providing strong evidence of oncological and survival equivalency. With the progressive growth of robot-assisted partial nephrectomy (RAPN) techniques, the use of several tools has been progressively developed to help the surgeon in the identification of masses and its vascular net. In this short review we tried to analyze the current use of intra-operative ultrasound as an operative tool to improve localization of small renal masses partially or completely endophytic during RAPN.

scholarly journals MP14-11 COST IMPLICATIONS OF NEPHRON SPARING OPTIONS FOR THE MANAGEMENT OF SMALL RENAL MASSES

2019 ◽  
Vol 201 (Supplement 4) ◽  
Author(s):  
Jeffrey Leow* ◽  
Ye Wang ◽  
Melissa Huynh ◽  
Alice Yu ◽  
Keng Siang Png ◽  
...  
Keyword(s):  
Small Renal Masses ◽  
Renal Masses ◽  
Nephron Sparing ◽  
Cost Implications

Renal function and oncologic outcomes in nephron sparing surgery for renal masses in solitary kidneys

2010 ◽  
Vol 29 (3) ◽  
pp. 343-348 ◽  
Author(s):  
Daniel J. Lee ◽  
Greg Hruby ◽  
Mitchell C. Benson ◽  
James M. McKiernan
Keyword(s):  
Renal Function ◽  
Nephron Sparing Surgery ◽  
Oncologic Outcomes ◽  
Renal Masses ◽  
Nephron Sparing

Is radical nephrectomy a legitimate therapeutic option in patients with renal masses amenable to nephron-sparing surgery?

2014 ◽  
Vol 115 (3) ◽  
pp. 357-363 ◽  
Author(s):  
Jeffrey J. Tomaszewski ◽  
Marc C. Smaldone ◽  
Robert G. Uzzo ◽  
Alexander Kutikov
Keyword(s):  
Radical Nephrectomy ◽  
Therapeutic Option ◽  
Nephron Sparing Surgery ◽  
Renal Masses ◽  
Nephron Sparing

Elective open nephron-sparing surgery for renal masses: Single-center experience with 223 consecutive patients

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. e16139-e16139
Author(s):  
F. Francesca ◽  
G. Pomara ◽  
G. Campo ◽  
P. Casale
Keyword(s):  
Postoperative Bleeding ◽  
Oncologic Outcome ◽  
Nephron Sparing Surgery ◽  
Consecutive Series ◽  
Renal Masses ◽  
Single Center Experience ◽  
Nephron Sparing ◽  
Urinary Fistulas

e16139 Background: To present our experience with elective, open, nephron-sparing surgery for renal masses in a contemporary, consecutive series. Methods: In this retrospective study, records of all patients who underwent elective nephron-sparing surgery (E-NSS) between March 1997 and December 2007 at our institution were reviewed. The preoperative workup included laboratory analysis, renal ultrasonography and abdominal computed tomography. The histological findings, complications, and oncologic outcome were studied. Results: A total of 231 E-NSS were performed in 223 patients (82 females,141males; mean age 64 years). 62 “hot ischemia” procedures and 169 “cold ischemia”. The mean tumor size was 4.6 cm (1.1–12cm). 52 patients presented renal masses > 4cm. Renal cell carcinoma was present in 177 patients (76.6%), benign renal masses were diagnosed in in 54 pazienti (23.3%): angiomyolipoma (35%), oncocytoma (40%), complicated cyst (25%). Worthy of note among these 54 patients, pre-operative diagnosis was present in 12 patients. Moreover, 17 benign lesions (31%) were > 4 cm. Complication rate was 5.3% (12 pts): splenectomy (2.2%), nephrectomy because of postoperative bleeding (0.8%), urinary fistulas (0.8%). After a median follow-up of 84 months (range 5 to 120), no patient had developed local recurrence, 19 (8.9%) died for other causes, 2 (0.9%) died for other tumor. Conclusions: The results of this contemporary, monocenter experience underline the role of open, elective, nephron-sparing surgery for patients with renal masses, confirming good results even for renal masses > 4cm. These conclusions are particularly important considering that benign histologic findings were present in almost one forth of patients. No significant financial relationships to disclose.

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