Renal Cell Carcinoma: Histological
Findings in Peritumoral Tissue after
Organ-Preserving Surgery

Costantini, Elisabetta; Mearini, Ettore; F, Ficola; Petroni, Pietro Antonio; Biscotto, Sauro; Monico, Silvio; Porena, Massimo

doi:10.1159/000473760

Cited by 13 publications

(3 citation statements)

References 10 publications

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“…This technique not only affords preservation of maximal renal parenchyma, but also makes isolation/ clamping of the renal vessels unnecessary, affording great surgical expedience and avoiding renal ischaemia. The major resistance to pure enucleation of RCC has stemmed from several histopathological studies that showed the capricious nature of the tumour pseudocapsule [9,[18][19][20][21]. The most recent and relevant of these is the report by Li et al [18], in which pathological specimens from 82 patients after radical nephrectomy for tumours of ≤ 4 cm were examined.…”

Section: Discussionmentioning

confidence: 99%

Enucleation of renal cell carcinoma with ablation of the tumour base

et al. 2008

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OBJECTIVE To retrospectively assess the effectiveness of cancer control with enucleation of renal cell carcinoma (RCC), which is surgically expedient, allows preservation of maximal renal parenchyma, and makes intraoperative renal ischaemia unnecessary, by two surgeons routinely enucleating renal tumours and ablating the tumour bed with argon beam and the Nd‐YAG laser. PATIENTS AND METHODS Between 1996 and 2006 at our institution, 97 patients had RCC enucleated, with ablation of the tumour base. Patients with lesions other than RCC and those with von Hippel‐Lindau disease or Birt‐Hogg‐Dube syndrome were excluded from the study. The mean follow‐up was 24.9 months. Patients were evaluated for RCC recurrence with cross‐sectional imaging at least every 6 months for the first 2 years and then annually thereafter. RESULTS The mean (median, range) tumour size was 2.8 (2.5, 0.8–7.0) cm. Of the 97 patients only one had disease progression after a mean follow‐up of 24.9 months. This patient presented with a solitary grade 2 clear cell RCC and had a local recurrence 30 months after original surgery. CONCLUSIONS The present series and other available clinical data suggest that enucleation with cavity ablation is an oncologically sound approach that is simple, versatile and obviates the need for renal ischaemia.

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Section: Discussionmentioning

confidence: 99%

Enucleation of renal cell carcinoma with ablation of the tumour base

et al. 2008

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“…Some renal tumours are surrounded by a distinct pseudocapsule of fibrous tissue, and simple enucleation has been used in such cases for tumour removal, but most recent studies have associated enucleation with a higher risk of residual malignancy in the kidney [32,33]. Histopathological studies have shown frequent microscopic tumour penetration of the pseudocapsule that surrounds the neoplasm [34,35], and so it is not always possible to be sure of complete tumour encapsulation. Every attempt should be made to prevent local tumour recurrence, and whenever possible a surrounding margin of normal parenchyma should be removed with the tumour.…”

Section: Operating Techniquementioning

confidence: 99%

Open partial nephrectomy for renal tumours: current status

Novick

Derweesh

2005

BJU International

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“…Therefore, NSS in patients with a small tumor and a normal contralateral kidney is under discussion in the literature [6][7][8][9][10]. The 64:192-197 193 statements about the maximum diameter which could be considered for this surgical procedure differ from 25 to 50 mm [6,8,[11][12][13].…”

Section: Introductionmentioning

confidence: 99%

How Accurate Is Diagnostic Imaging in Determination of Size and Multifocality of Renal Cell Carcinoma as a Prerequisite for Nephron-Sparing Surgery?

Schlichter

Schubert²,

Werner³

et al. 2000

Urol Int

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Background: The indication for elective nephron-sparing surgery (NSS) in renal cell carcinoma (RCC) is under discussion in the urological literature. The main problem of NSS is the multifocality of RCC. The presented study was performed to asses the accuracy of pre- and intraoperative ultrasound (US), and computerized tomography (CT) in determination of tumor size and detection of multifocal lesions. Materials and Methods: Tumor size was measured by preoperative US and CT and compared with the tumor diameters in gross sections of the neoplastic kidneys. Multifocality was determined by 3-mm step sectioning of the nephrectomy specimen, and the results were correlated with preoperative US and CT on the one hand, and the ex situ sonography of the nephrectomized kidney on the other hand. Results: US and CT show similar results in the determination of the tumor size. In only 22.9%, preoperative US and CT were able to detect multifocal tumors. Ex situ sonography had a sensitivity of 40.0% and a specificity of 87.2% in this regard. Conclusions: In preparation for nephron-sparing surgery of renal cell carcinoma, neither preoperative routine imaging, nor intraoperative ultrasound can safely predict multifocal lesions of renal cell carcinoma.

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Renal Cell Carcinoma: Histological Findings in Peritumoral Tissue after Organ-Preserving Surgery

Cited by 13 publications

References 10 publications

Enucleation of renal cell carcinoma with ablation of the tumour base

Enucleation of renal cell carcinoma with ablation of the tumour base

Open partial nephrectomy for renal tumours: current status

How Accurate Is Diagnostic Imaging in Determination of Size and Multifocality of Renal Cell Carcinoma as a Prerequisite for Nephron-Sparing Surgery?

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