The Urologic clinics of North America
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Urol. Clin. North Am. · May 2012
Review Comparative StudyThe influence of surgical approach to the renal mass on renal function.
The National Kidney Foundation estimates that 26 million Americans are living with chronic kidney disease (CKD). The high prevalence of obesity, heart disease, hypertension, and diabetes places millions more at risk for developing CKD. Although long-term sufficient renal function is routine in screened kidney donors, CKD is present in more than 30% of patients with a newly diagnosed renal mass and develops in most patients who undergo radical nephrectomy and a portion of those who undergo nephron-sparing approaches. Herein, the authors review the effect of the surgical approach on renal function for patients presenting with a renal mass.
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Urol. Clin. North Am. · May 2012
ReviewIntegration of surgery and systemic therapy for renal cell carcinoma.
Proper integration of surgery and systemic therapy is essential for improving outcomes in renal cell carcinoma (RCC). There is no current role for adjuvant therapy after nephrectomy for clinically localized disease. ⋯ Presurgical targeted therapy is feasible and may be beneficial. Pending the results of randomized controlled trials, upfront cytoreductive nephrectomy in appropriate patients will likely continue as the paradigm of choice in metastatic RCC.