Open Access

REVIEW

What is the current role of partial nephrectomy for T2 tumors?

Bruno Nahar, Mark L. Gonzalgo

Department of Urology, University of Miami Miller School of Medicine, Miami, Florida, USA
Address correspondence to Dr. Bruno Nahar, Department of Urology, University of Miami Miller School of Medicine, 1120 NW 14th Street, Suite 1564, Miami, FL 33136 USA

Canadian Journal of Urology 2017, 24(2), 8698-8704.

Abstract

Introduction: To review oncological and functional outcomes for partial nephrectomy in the setting of T2 tumors.
Materials and methods: We performed a comprehensive literature review on partial nephrectomy for T2 tumors, focusing on major primary series reporting oncological and functional outcomes, as well as complication rates in the last 10 years.
Results: Recent series have reported comparable oncological outcomes between partial nephrectomy and radical nephrectomy for ≥ T2 tumors. However, most of these studies are retrospective in design with small sample sizes. With regard to functional outcomes, partial nephrectomy outperforms radical nephrectomy. However, outcomes are dependent on the amount of residual renal parenchyma left after partial nephrectomy for larger tumors. Partial nephrectomy is associated with an increased rate of complications when compared to radical nephrectomy, but in experienced hands this increase tends to remain at an acceptable level. There are few studies that have investigated the role of minimally invasive surgery (MIS) in the setting of T2 tumors. Although MIS techniques may be underutilized for management of T2 tumors, it is a feasible approach in highly selected patients.
Conclusions: Partial nephrectomy has emerged as an acceptable alternative for surgical management of T2 renal tumors over the last decade. Nephron-sparing surgery demonstrates similar oncological outcomes compared to radical nephrectomy and can be considered even for larger tumors in carefully selected patients whenever feasible.

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