Partial and Radical Nephrectomy

Partial and Radical Nephrectomy

Partial nephrectomy is generally performed for confirmed or suspected kidney cancer and entails removing the tumor along with a small margin of healthy kidney tissue surrounding it. The goals are to preserve as much of your normal, healthy kidney as possible while achieving complete cancer control. It is a highly reliable surgical procedure associated with excellent oncological and renal functional results. Radical nephrectomy entails complete removal of the affected kidney along with its bed of natural surrounding fatty tissue (Gerota’s fascia), with or without removal of its accompanying adrenal gland. This is usually only necessary when the tumor is very large, aggressive or is in a location that would make partial nephrectomy unsafe or not possible.

What techniques are available for my surgeon to perform these procedure?

Several factors are taken into consideration when determining the best treatment plan for you. In general, Dr. Horovitz may perform the procedure laparoscopically, using robotic-assisted technology or through a standard open incision.

What other methods are available to treat my kidney tumor aside from surgery?

Other minimally invasive treatment options are available such as cryoablation or radiofrequency ablation. These techniques are generally performed by a radiologist who treats the tumor by placing a special probe into it under imaging guidance through your skin. The tumor is treated with multiple freeze and thaw cycles (cryoablation) or with the application of high-frequency electrical current to heat the tumor (radiofrequency ablation). Both techniques are safe and can achieve good cancer control when the tumor is less than 3 cm and is in a location that is amenable to such procedures. If the tumor is close to important structures such as your ureter, colon or the major blood vessels that supply the kidney, these methods will generally not be offered due to safety concerns.

Do I need to treat my kidney tumor at all?

In general, yes. However, some very select tumors may be safely observed without treatment, depending on a multitude of factors including the size and pathological features of the tumor as well as your age, general health, prior treatments and competing medical comorbidities. This option, termed “active surveillance” should only be pursued under the strict supervision of your urologist and requires very close follow-up with serial imaging studies as treatment may be required if there is evidence of disease progression. Surgical excision (partial or radical nephrectomy) is still considered the gold standard for the treatment of most kidney tumors.

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