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2015 ; 4
(3
): 294-300
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Outlining the limits of partial nephrectomy
#MMPMID26236649
Chopra S
; Satkunasivam R
; Kundavaram C
; Liang G
; Gill IS
Transl Androl Urol
2015[Jun]; 4
(3
): 294-300
PMID26236649
show ga
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.