Skip to main content

Abstract

Renal cell carcinoma as we know today is primarily a surgical disease. The modern era of radical nephrectomy for the treatment of renal cell carcinoma was described by Robson et al.1 The technique of radical nephrectomy can be performed in a variety of ways, but the firm principles outlined by Robson remain relevant today. Robson and associates described removing the kidney with early ligation of the renal artery and vein to minimize tumor emboli, and a lymph node dissection, removing the paraaortic and paracaval nodal packets from the crus of the diaphragm superiorly to the aortic bifurcation inferiorly. Since that time, the technique of radical nephrectomy has undergone some modification, but the general principles outlined remain germane to today’s contemporary practice.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 129.00
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD 169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Robson CJ, Churchill BM, Anderson W. The results of radical nephrectomy for renal cell carcinoma. J Urol 1969;101:297.

    CAS  PubMed  Google Scholar 

  2. Turner-Warwick RT. The supracostal approach to the renal area. Br J Urol 1965;37:671–672.

    Article  CAS  PubMed  Google Scholar 

  3. Skinner DG, Vermilion CD, Colvin RB. The surgical management of renal cell carcinoma. J Urol 1972;107:705.

    CAS  PubMed  Google Scholar 

  4. Selli C, Hinshaw WM, Woodard BH, et al. Stratification of risk factors in renal cell carcinoma. Cancer 1983;52:899.

    Article  CAS  PubMed  Google Scholar 

  5. Golimbu M, Joshi P, Sperber A, Tessler A, Al-Askari S, Morales P. Renal cell carcinoma: survival and prognostic factors. Urology 1986;27(4):291–301.

    Article  CAS  PubMed  Google Scholar 

  6. McNichols DW, Segura JW, DeWeerd JH. Renal cell carcinoma: long term survival and late recurrences. J Urol 1981;126:17.

    CAS  PubMed  Google Scholar 

  7. Sagalowsky AI, Kadesky KT, Ewalt DM, Kennedy TJ. Factors influencing adrenal metastasis in renal cell carcinoma. J Urol 1994;151:1181–1184.

    CAS  PubMed  Google Scholar 

  8. Robey EL, Schellhammer PF. The adrenal gland and renal cell carcinoma: is ipsilateral adrenalectomy a necessary component of radical nephrectomy? J Urol 1986;135:453–455.

    CAS  PubMed  Google Scholar 

  9. Winter P, Miersch WD, Vogel J, Jaeger N. On the necessity of adrenal extirpation combined with radical nephrectomy. J Urol 1990;144:842–844.

    CAS  PubMed  Google Scholar 

  10. Tsui KH, Shvarts O, Barbaric Z, Figlin R, deKernion JB, Belldegrun A. Is adrenalectomy a necessary component of radical nephrectomy? UCLA experience with 511 radical nephrectomies. J Urol 2000; 163:437–441.

    Article  CAS  PubMed  Google Scholar 

  11. Peters PC, Brown GL. The role of lymphadenectomy in the management of renal cell carcinoma. Urol Clin North Am 1980;7(3):705–709.

    CAS  PubMed  Google Scholar 

  12. Giuliani L, Giberti C, Martorana G, Rovida S. Radical extensive surgery for renal cell carcinoma: long-term results and prognostic factors. J Urol 1990;143:468–474.

    CAS  PubMed  Google Scholar 

  13. De Kernion JB. Lymphadenectomy for renal cell carcinoma. Urol Clin North Am 1980; 7(3):697–703.

    Google Scholar 

  14. Siminovitch JP, Montie JE, Straffon RA. Lymphadenectomy in renal adenocarcinoma. J Urol 1982;127:1090–1091.

    CAS  PubMed  Google Scholar 

  15. Marshall FF. Lymphadenectomy for renal cell carcinoma. BJU Int 2005;95(suppl 2):34.

    Article  PubMed  Google Scholar 

  16. Pantuck AJ, Zisman A, Dorey F, et al. Renal cell carcinoma with retroperitoneal lymph nodes. Impact on survival and benefits of immunotherapy. Cancer 2003;97(12):2995–3002.

    Article  PubMed  Google Scholar 

  17. Kearney GP, Waters WB, Klein LA, Richie JP, Gittes RF. Results of inferior vena cava resection for renal cell carcinoma. J Urol 1981;125:769.

    CAS  PubMed  Google Scholar 

  18. Berg AA. Malignant hypernephroma of the kidney. Its clinical course and diagnosis with a description of the author’s method of radical operative cure. Surg Gynecol Obstet 1913;17:463.

    Google Scholar 

  19. Huang WC, Rhee HK, Mourtzinos AP, et al. Hyponatremia is a potentially serious complication following renal angioinfarction. J Urol 2003;169(4, suppl): abstr 115.

    Google Scholar 

  20. Munro NP, Woodhams S, Nawrocki JD, Fletcher MS, Thomas PJ. The role of transarterial embolization in the treatment of renal cell carcinoma. BJU Int 2003;92:240–244.

    Article  CAS  PubMed  Google Scholar 

  21. Libertino JA, Zinman L, Watkins E. Long term results of resection of renal cell cancer with extension into inferior vena cava. J Urol 1987;137:21–24.

    CAS  PubMed  Google Scholar 

  22. Fitzgerald JM, Tripathy U, Svensson LG, Libertino JA. Radical nephrectomy with vena caval thrombectomy using a minimal access approach for cardiopulmonary bypass. J Urol 1998;159(4):1292–1293.

    Article  CAS  PubMed  Google Scholar 

  23. Wotkowicz C, Libertino JA, Sorcini A, Mourtzinos AP. Management of renal cell carcinoma with vena cava and atrial thrombus: minimal access versus median sternotomy with circulatory arrest. BJU Int 2006;98(2):289–297.

    Article  PubMed  Google Scholar 

  24. Sogani PC, Herr HW, Rains MS, Whitmore WF. Renal cell carcinoma extending into inferior vena cava. J Urol 1983;130:660–663.

    CAS  PubMed  Google Scholar 

  25. Neves RJ, Zincke H. Surgical treatment of renal cancer with vena cava extension. Br J Urol 1987;59:390–395.

    Article  CAS  PubMed  Google Scholar 

  26. Swierzewski DJ, Swierzewski MJ, Libertino JA. Radical nephrectomy in patients with renal cell carcinoma with venous, vena caval, and atrial extension. Am J Surg 1994;168(2):205–209.

    Article  CAS  PubMed  Google Scholar 

  27. Skinner DG, Pfister RF, Colvin R. Extension of renal cell carcinoma into the vena cava: the rationale for aggressive surgical management. J Urol 1972;107:711.

    CAS  PubMed  Google Scholar 

  28. Naitoh J, Kaplan A, Dorey F, Figlin R, Belldegrun A. Metastatic renal cell carcinoma with concurrent inferior vena caval invasion: long-term survival after combination therapy with radical nephrectomy, vena caval thrombectomy, and postoperative immunotherapy. J Urol 1999;162:46–50.

    Article  CAS  PubMed  Google Scholar 

  29. Suggs WD, Smith RB, Dodson TF, Salam AA, Graham SD. Renal cell carcinoma with inferior vena caval involvement. J Vasc Surg 1991;14:413–418.

    Article  CAS  PubMed  Google Scholar 

  30. Hatcher PA, Anderson EE, Paulson DF, Carson CC, Robertson JE. Surgical management and prognosis of renal cell carcinoma invading the vena cava. J Urol 1991;145:20–24.

    CAS  PubMed  Google Scholar 

  31. Skinner DG, Pritchett TR, Lieskovsky G, Boyd SD, Stiles QR. Vena caval involvement by renal cell carcinoma. Ann Surg 1989;210(3):387–394.

    Article  CAS  PubMed  Google Scholar 

  32. Sosa RE, Muecke EC, Vaughan ED, McCarron JP. Renal cell carcinoma extending into the inferior vena cava: the prognostic significance of the level of vena caval involvement. J Urol 1984;132:1097–1100.

    CAS  PubMed  Google Scholar 

  33. Nesbitt JC, Soltero ER, Cinney CPN, et al. Surgical management of renal cell carcinoma with inferior vena cava tumor thrombus. Ann Thorac Surg 1997;63:1592–1600.

    Article  CAS  PubMed  Google Scholar 

  34. Moinzadeh A, Libertino JA. Prognostic significance of tumor thrombus level in patients with renal cell carcinoma and venous tumor thrombus extension. Is all T3b the same? J Urol 2004;171: 598–601.

    Article  PubMed  Google Scholar 

  35. Kim HL, Zisman A, Han KR, Figlin RA, Belldegrun A. Prognostic significance of venous thrombus in renal cell carcinoma. Are renal vein and inferior vena cava involvement different? J Urol 2004;171:588–591.

    Article  PubMed  Google Scholar 

  36. Mattox KL, Feldtman RW, Beall AC, DeBakey ME. Pulmonary embolectomy for massive pulmonary embolism. Ann Surg 1982;195(6):726–731.

    Article  CAS  PubMed  Google Scholar 

  37. Desai MM, Gill IS, Ramani AP, Matin SF, Kaouk JH, Campero JM. Laparoscopic radical nephrectomy for cancer with level I renal vein involvement. J Urol 2003;169:487–491.

    Article  PubMed  Google Scholar 

  38. Meraney AP, Gill IS, Desai MM, et al. Laparoscopic inferior vena cava and right atrial thrombectomy utilizing deep hypothermic circulatory arrest. J Endourol 2003;17(5):275–282.

    Article  PubMed  Google Scholar 

  39. Varkarakis IM, Bhayani SB, Allaf ME, Inagaki T, Gonzalgo ML, Jarrett TW. Laparoscopic-assisted nephrectomy with inferior vena cava tumor thrombectomy: preliminary results. Urology 2004;64: 925–929.

    Article  PubMed  Google Scholar 

  40. Sundaram CP, Rehman J, Landman J, Oh J. Hand assisted laparoscopic radical nephrectomy for renal cell carcinoma with inferior vena caval thrombus. J Urol 2002;168:176–179.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2008 Humana Press Inc., Totowa, NJ

About this chapter

Cite this chapter

Chung, B.I., Libertino, J.A. (2008). Radical Nephrectomy. In: Bukowski, R.M., Novick, A.C. (eds) Clinical Management of Renal Tumors. Humana Press. https://doi.org/10.1007/978-1-60327-149-3_11

Download citation

  • DOI: https://doi.org/10.1007/978-1-60327-149-3_11

  • Publisher Name: Humana Press

  • Print ISBN: 978-1-58829-251-3

  • Online ISBN: 978-1-60327-149-3

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics