Surgical management of large renal tumors

Abstract

The surgical management of patients with renal cell carcinoma has undergone many changes. With equivalent oncologic outcomes and appreciation of the importance of renal functional preservation, the utilization of nephron-sparing partial nephrectomy has increased in recent years. Nevertheless, tumors of larger size continue to be preferentially treated with radical nephrectomy. Here, we present evidence that improvements in techniques and durability of oncologic outcomes has justified the use of nephron sparing to accomplish renal functional preservation even in patients with large renal tumors. In addition, surgical technical considerations when managing such tumors are discussed. Finally, we discuss cytoreductive surgery and the evolving role of systemic targeted therapies in the management of advanced metastatic disease.

Treatment difficulties during COVID 19 pandemic in a patient with giant renal tumor. A small town general hospital perspective

“…Surgical extirpation remains the standard treatment for patients with renal cell carcinoma [10]. Due to the major advances made in medical field, minimal invasive treatment represent an important option for patients with renal tumoral mass.…”

Surgical challenges in the treatment of a giant renal cell carcinoma with atypical presentation: A case report

“…Surgical resection remains the gold standard treatment for RCC as a result of excellent oncologic outcomes [10] . The tumor resected in this case is a testament to the indolent course that can be seen with RCC.…”

“…These options are null in cases such as this when tumor size is very large. In instances such as this when an open resection must be performed, anterior approaches are safest as they allow excellent visualization of the great vessels and renal hilum [10] .…”