Organ-sparing procedures in GU cancer: part 1—organ-sparing procedures in renal and adrenal tumors: a systematic review

  • Raouf Seyam
  • Mahmoud I. Khalil
  • Mohamed H. Kamel
  • Waleed M. Altaweel
  • Rodney Davis
  • Nabil K. BissadaEmail author
Urology - Review



Organ-sparing surgery (OSS) for the kidney and adrenals has emerged as the need for preservation of function is paramount in patients with poor functional reserve. As reports increasingly showed that oncological outcomes were equivalent to radical excision, elective OSS became a viable alternative in patients with otherwise normal reserve. In this review, we summarize the current knowledge of OSS for adrenal and renal tumors.

Materials and methods

PubMed, Web of Science and Cochrane Library Central Search were searched for recently published articles up to December 2017. The following keywords were used; “partial adrenalectomy”, “adrenal sparing”, “partial nephrectomy”, “nephron sparing”, “kidney/renal cancer”.


Partial adrenalectomy became an attractive alternative to total adrenalectomy avoiding adrenal insufficiency. Both minimally invasive surgery and ablative techniques were increasingly reported for adrenal OSS with adequate residual adrenal function and excellent oncological outcome. Radical nephrectomy remained for many years as the gold standard of treatment for organ-confined renal cell carcinoma. As the need to reduce the impact on renal function, more conservative approaches were utilized. Soon, the non-inferiority of nephron-sparing surgery to that of radical excision became evident and elective partial nephrectomy was gaining ground as the standard of care for small renal masses in patients with normal contralateral kidneys.


Herein, we present a comprehensive review of the current status of OSS in renal and adrenal tumors.


Organ sparing Nephron sparing Partial nephrectomy Partial adrenalectomy 



Active surveillance


Chronic kidney disease


Cancer-specific survival


Disease-free survival


Laparoscopic partial nephrectomy


Nephron-sparing surgery


Partial nephrectomy


Renal cell carcinoma


Radiofrequency ablation


Recurrence-free rate


Radical nephrectomy


Robotic partial nephrectomy


Percutaneous thermal ablation


Stereotactic ablative radiotherapy


Small renal masses


Surveillance, Epidemiology, and End Results


Thermal ablation


Warm ischemia time


Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.


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Copyright information

© Springer Nature B.V. 2019

Authors and Affiliations

  • Raouf Seyam
    • 1
  • Mahmoud I. Khalil
    • 2
  • Mohamed H. Kamel
    • 2
  • Waleed M. Altaweel
    • 1
  • Rodney Davis
    • 2
  • Nabil K. Bissada
    • 3
    Email author
  1. 1.Department of UrologyKing Faisal Specialist Hospital and Research CenterRiyadhSaudi Arabia
  2. 2.Department of UrologyUniversity of Arkansas for Medical SciencesLittle RockUSA
  3. 3.Department of UrologyBaylor College of Medicine and Michael E. De Bakey VA Medical CenterHoustonUSA

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