TY - JOUR
T1 - Outlining the limits of partial nephrectomy
AU - Chopra, Sameer
AU - Satkunasivam, Raj
AU - Kundavaram, Chandan
AU - Liang, Gangning
AU - Gill, Inderbir S.
PY - 2015
Y1 - 2015
N2 - Amongst nephron-sparing modalities, partial nephrectomy (PN) is the standard of care in the treatment of renal cell carcinoma (RCC). Despite the increasing utilization of PN, particularly propagated by robot-assisted, minimally invasive approaches for small renal masses (SRMs), the limits of PN appear to be also evolving. In this review, we sought to address the tumour stage beyond which PN may be oncologically perilous. While the evidence supports PN in the treatment of tumours < pT2a, PN may have a role in advanced or metastatic RCC. Other scenarios wherein PN has limited utility are also explored, including anatomical or surgical factors that dictate the difficulty of the case, such as prior renal surgery. Lastly, we discuss the emerging role of molecular biomarkers, specifically epigenetics, to aid in the risk stratification of SRMs and to select tumours optimally suited for PN.
AB - Amongst nephron-sparing modalities, partial nephrectomy (PN) is the standard of care in the treatment of renal cell carcinoma (RCC). Despite the increasing utilization of PN, particularly propagated by robot-assisted, minimally invasive approaches for small renal masses (SRMs), the limits of PN appear to be also evolving. In this review, we sought to address the tumour stage beyond which PN may be oncologically perilous. While the evidence supports PN in the treatment of tumours < pT2a, PN may have a role in advanced or metastatic RCC. Other scenarios wherein PN has limited utility are also explored, including anatomical or surgical factors that dictate the difficulty of the case, such as prior renal surgery. Lastly, we discuss the emerging role of molecular biomarkers, specifically epigenetics, to aid in the risk stratification of SRMs and to select tumours optimally suited for PN.
KW - Indications
KW - Limits
KW - Partial nephrectomy (PN)
KW - Radical nephrectomy (RN)
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U2 - 10.3978/j.issn.2223-4683.2015.06.04
DO - 10.3978/j.issn.2223-4683.2015.06.04
M3 - Review article
AN - SCOPUS:84934281841
SN - 2223-4683
VL - 4
SP - 294
EP - 300
JO - Translational Andrology and Urology
JF - Translational Andrology and Urology
IS - 3
ER -