ORGAN-PRESERVING SURGERY OF RENAL-CELL CARCINOMA

Operative method, course and complications were analysed retrospectively in 120 resected without nephrectomy. In 49 patients (18 women and 31 men, mean age 59 [38-77] years; 45 renal-cell carcinomas, 4 beging renal tumours) there was an >>imperative indication<< for an organ-preserving operation, because nephrectomy would have made dialysis obligatory. In 74 patients with a healthy contralateral kidney (25 women, 49 men, mean age 55 [31-74] years; 61 renal-cell carcinomas, 13 benign tumours) the tumour was enucleated by choice; 55 of these patients were symptom-free. 36 of 49 patients with an imperative indication are without sign of tumour progression after a mean follow-up period of 4.5 years. In two there was a recurrence after 4 and 5 years, respectively, requiring a second organ-preserving operation. Known metastases were present in 3 of 6 patients who died of their tumours. 68 of 74 patients operated on electively are without signs of tumour progression after a mean follow-up period of 3.3 years. One patient died from tumour metastases. Two patients had tumour recurrence, requiring nephrectomy and enucleation, respectively.