Skip to main content
SpringerLink
Log in

Surgical Management of Renal Cell Carcinoma

  • Chapter
Renal and Adrenal Tumors

Abstract

In the absence of distant metastases, radical nephrectomy is the treatment of choice for renal carcinoma. The operative procedure has been described by Chute et al. [12] and FOLEY et al. [19]. It includes preliminary ligation of the artery and vein of the tumor-bearing kidney, with subsequent en bloc removal of the kidney and the perinephric fat, the intact Gerota’s capsule, and the ipsilateral adrenal gland. The rationale for this widely accepted surgical strategy is based on data obtained by Robson et al. [64]. They were able to demonstrate that radical nephrectomy increased the 5-year survival rate to 52%, compared with 33% for simple nephrectomy, and the 10-year survival rate from 7.1% to 49%. Fuseler etal. [21], however, did not find any differences in long-term survival after radical or simple nephrectomy.

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

Access this chapter

Log in via an institution
eBook
USD 16.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 109.99
Price excludes VAT (USA)
  • Compact, lightweight 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. Abdelsayed M, Bissada N, Finkbeiner A, Redman J (1978) Renal tumors involving the inferior vena cava: plan for management. J Urol 120: 153

    PubMed  CAS  Google Scholar 

  2. Almgard L, Fernstrom J, Haverling M, Ljungquist A (1973) Treatment of renal adenocarcinoma by embolic occlusion of the renal circulation. Br J Urol 45: 474

    Article  PubMed  CAS  Google Scholar 

  3. Angervall L, Wahlquist L (1978) Follow-up and prognosis of renal carcinoma in a series operated by perifascial nephrectomy combined with adrenalectomy and retroperitoneal lymphadenectomy. Eur Urol 4: 13

    PubMed  CAS  Google Scholar 

  4. Bakke A, Goethlin J, Hoisaeter P (1985) Renal malignancies: outcome of patients in stage 4 with or without embolization procedure. Urology 26: 541

    Article  PubMed  CAS  Google Scholar 

  5. Banowsky L (1982) Renal in situ surgery, partial nephrectomy and renal autotransplantation. In: Crawford E, Borden T (eds) Genitourinary cancer surgery. Lea and Febiger, Philadelphia, p 52

    Google Scholar 

  6. Bassil B, Dosoretz D, Prout G Jr (1985) Validation of the tumor, nodes and metastasis classification of renal cell carcinoma. J Urol 134: 450

    PubMed  CAS  Google Scholar 

  7. Boileau M (1982) Cancer of the kidney: overview. In: Johnson RE, Boileau MA (eds) Genitourinary tumors; fundamental principles and surgical techniques. Grune and Stratton, p 293

    Google Scholar 

  8. Carini M, Selli C, Muraro G, Trippitelli A, Masini G, Turini D (1981) Conservative surgery for renal cell carcinoma. Eur Urol 7: 19

    PubMed  CAS  Google Scholar 

  9. Chatelain C (1982) Results of radical nephrectomy without lymphadenectomy in renal cell carcinoma. In: Kuss R, Murphy G, Khoury S, Karr J (eds) Renal tumors: proceedings of the first international symposium on kidney tumors. Alan R Liss, New York, p 475

    Google Scholar 

  10. Cherrie R, Goldman D, Lindner A, de Kernion J (1982) Prognostic implications of vena caval extension of renal cell carcinoma. J Urol 128: 910

    PubMed  CAS  Google Scholar 

  11. Christensen K, Dyreborg U, Anderson J, Nissen H (1985) The value of transvascular embolization in the treatment of renal carcinoma. J Urol 133: 191

    PubMed  CAS  Google Scholar 

  12. Chute R, Soutter L, Kerr W Jr (1949) The value of the thoraco-abdominal incision in the removal of kidney tumors. New Engl J Med 241: 951

    Article  PubMed  CAS  Google Scholar 

  13. Clayman R, Gonzalez R, Fraley E (1980) Renal cell cancer invading the inferior vena cava: clinical review and anatomical approach. J Urol 123: 157

    PubMed  Google Scholar 

  14. de Kernion J, Ramming K, Smith R (1978) The natural history of metastatic renal cell carcinoma: a computer analysis. J Urol 120: 148

    Google Scholar 

  15. de Kernion J, Berry D (1980) The diagnosis and treatment of renal cell carcinoma. Cancer 45: 1947

    Google Scholar 

  16. Dreikorn K, Terweg B, Drings P, Horsch R, Palmtag H, Rossler W (1983) Complete regression of multiple pulmonary metastases in a patient with advanced renal cell carcinoma treated by occlusion of the renal artery with subsequent radical nephrectomy and progesterone. Eur Urol 9: 254

    PubMed  CAS  Google Scholar 

  17. Ellman B, Green C, Eigenbrodt E, Garriott J, Curry T (1980) Renal infarction with absolute ethanol. Invest Radiol 15: 318

    Article  PubMed  CAS  Google Scholar 

  18. Flocks R, Kadesky M (1958) Malignant neoplasms of the kidney: an analysis of 353 patients followed five years or more. J Urol 79: 196

    PubMed  CAS  Google Scholar 

  19. Foley F, Mulvaney W, Richardson E, Victor J (1952) Radical nephrectomy for neoplasm. J Urol 68: 39

    PubMed  CAS  Google Scholar 

  20. Fowler J Jr (1986) Failure of immunotherapy for metastatic renal cell carcinoma. J Urol 135: 22

    PubMed  Google Scholar 

  21. Fuselier H Jr, Guice S, Brannan W, Ochsner M, Sangisett K, Beckman E, Barnes C (1983) Renal cell carcinoma: The Ochsner medical institution experiences (1945–1978). J Urol 130: 445

    PubMed  Google Scholar 

  22. Gilloz A, Tostain J (1982) Comparative study of actuarial survival rates in stage II and III renal cell carcinoma managed by radical nephrectomy alone or associated with formal retroperitoneal lymph node dissection. In: Kuss R, Murphy G, Khoury S, Karr J (eds) Symposium on kidney tumors. Alan R Riss, New York, p 489

    Google Scholar 

  23. Giuliani L, Martorana G, Giberti C, Pescatore D, Magnani G (1983) Results of radical nephrectomy with extensive lymphadenectomy for renal cell carcinoma. J Urol 130: 664

    PubMed  CAS  Google Scholar 

  24. Graham S Jr, Glenn J (1979) Enucleative surgery for renal malignancy. J Urol 122: 546

    PubMed  Google Scholar 

  25. Gregoir W (1982) Thoracophrenolaparotomy. In: Kiiss R, Murphy G, Khoury S, Karr J (eds) Renal tumors: proceedings of the first international symposium on kidney tumors. Liss, New York, p 453

    Google Scholar 

  26. Hellstein S, Berge T, Linell F (1983) Clinically unrecognised renal carcinoma: aspects of tumor morphology, lymphatic and haematogenous metastatic spread. Br J Urol 55: 166

    Article  Google Scholar 

  27. Heney N, Nocks B (1982) The influence of perinephric fat involvement on survival in patients with renal cell carcinoma extending into the inferior vena cava. J Urol 128: 18

    PubMed  CAS  Google Scholar 

  28. Herrlinger A, Sigel A, Giedl J (1984) Methodik der radikalen transabdominalen Tumornephrektomie mit fakultativer oder systematischer Lymphdissektion und deren Ergebnisse an 381 Patienten. Urologe A 23: 267

    PubMed  CAS  Google Scholar 

  29. Holland J (1973) Cancer of the kidney — natural history and staging. Cancer 432: 1030

    Article  Google Scholar 

  30. Hubmer G, Guad H, Vilits P (1984) Renal carcinoma with solitary distant metastasis. Urol Int 39: 46

    Article  PubMed  CAS  Google Scholar 

  31. Hulten L (1969) Rosencrantz M, Seeman T, Wahlquist L, Ahren C (1969) Occurrence and localization of lymph node metastases in renal carcinoma. Scand J Urol Nephrol 3: 129

    Article  PubMed  CAS  Google Scholar 

  32. Jacobs S, Berg R, Lawson K (1984) Synchronous bilateral renal cell carcinoma: total surgical excision. Cancer 46: 2341

    Article  Google Scholar 

  33. Jaeger N, Weissbach L, Vahlensieck W (1985) Value of enucleation of tumor in solitary kidneys. Eur Urol 11: 369

    PubMed  CAS  Google Scholar 

  34. Johnson D, Kaesler K, Samuels M (1975) Is nephrectomy justified in patients with metastatic renal carcinoma. J Urol 114: 27

    PubMed  CAS  Google Scholar 

  35. Kaisary A, Williams G, Riddle P (1984) The role of preoperative embolization in renal cell carcinoma. J Urol 131: 641

    PubMed  CAS  Google Scholar 

  36. Kearney G, Waters W, Klein L, Richie J, Gittes R (1981) Results of inferior vena cava resection for renal cell carcinoma. J Urol 125: 769

    PubMed  CAS  Google Scholar 

  37. Khoury S (1982) Lumbar flank approach. Kiiss R, Murphy G, Khoury S, Karr J (eds) Renal tumors: proceedings of the first international symposium on kidney tumors. Liss, New York, p 457

    Google Scholar 

  38. Klimberg J, Hunter P, Hawkins F, Drylie D, Wajsman Z (1985) Preoperative angioinfarction of localized renal cell carcinoma using absolute ethanol. J Urol 133: 21

    PubMed  CAS  Google Scholar 

  39. Konriak J, Grossman H (1985) Renal cell carcinoma as an incidental finding. J Urol 134: 1094

    Google Scholar 

  40. Küss R (1982) Conservative surgery in renal cell carcinoma. In: Küss R, Murphy G, Khoury S, Karr J (eds) Renal tumors: proceedings of the first international symposium on kidney tumors. Liss, New York, p 519

    Google Scholar 

  41. Malek R, Utz D, Culp O (1976) Hypernephroma in the solitary kidney: experience with 20 cases and review of the literature. J Urol 116: 553

    PubMed  CAS  Google Scholar 

  42. Marberger M, Pugh R, Auvert J, Bertermann H, Costantini A, Gammelgaard P, Petterson S, Wickham J (1981) Conservative surgery of renal carcinoma. The EIRSS experience. Brit J Urol 53: 528

    Article  PubMed  CAS  Google Scholar 

  43. Marshall F, Powell K (1982) Lymphadenectomy for renal cell carcinoma: anatomical and therapeutic considerations. J Urol 128: 677

    PubMed  CAS  Google Scholar 

  44. Marshall R, Reitz B, Diamond D (1984) A new technique for management of renal cell carcinoma involving the right atrium: hypothermia and cardiac arrest. J Urol 131: 103

    PubMed  CAS  Google Scholar 

  45. Marshall F, Reitz B (1985) Supradiaphragmatic renal cell carcinoma tumor thrombus: indications for vena caval reconstruction with pericardium. J Urol 133: 266

    PubMed  CAS  Google Scholar 

  46. Marx F, Chaussy C, Moser E (1982) Grenzen und Ge- fahren der palliativen Embolisation inoperabler Nieren- tumoren. Urologe A 21: 206

    PubMed  CAS  Google Scholar 

  47. Mazeman E, Wemeau L (1975) Les limites du traitement chirurgical du cancer du rein. J Urol Nephrol 80: 82

    Google Scholar 

  48. McCullough D, Gittes R (1974) Vena cava resection for renal cell carcinoma. J Urol 112: 162

    PubMed  CAS  Google Scholar 

  49. McDonald M (1982) Current therapy for renal cell carcinoma. J Urol 127: 211

    PubMed  CAS  Google Scholar 

  50. McNichols D, Segura J, De Weerd J (1981) Renal cell carcinoma: long-term survival and late recurrence. J Urol 126: 17

    PubMed  CAS  Google Scholar 

  51. Middleton R (1967) Surgery for metastatic renal cell carcinoma. J Urol 97: 973

    PubMed  CAS  Google Scholar 

  52. Middleton R, Presto A (1973) Radical thoracoabdominal nephrectomy for renal cell carcinoma. J Urol 110: 36

    PubMed  CAS  Google Scholar 

  53. Miedema B, Stubenbord W (1984) Irreversible renal failure following right nephrectomy and left renal vein ligation. J Urol 132: 335

    PubMed  CAS  Google Scholar 

  54. Montie J, Stewart B, Straffon R, Banowsky L, Hewitt C, Montague D (1977) The role of adjunctive nephrectomy in patients with metastatic renal cell carcinoma. J Urol 117: 272

    PubMed  CAS  Google Scholar 

  55. Morales A, Wilson J, Pater J, Loeb M (1982) Cytoreduc- tive surgery and systemic bacillus calmette-guerin therapy in metastatic renal cancer: a phase II trial. J Urol 127: 230

    PubMed  CAS  Google Scholar 

  56. Novick A, Stewart B, Straffon R, Banowsky L (1977) Partial nephrectomy in the treatment of renal adenocarcinoma. J Urol 118: 932

    PubMed  CAS  Google Scholar 

  57. Nurmi M (1984) Prognostic factors in renal carcinoma. An evaluation of operative findings. Br J Urol 56: 270

    Article  PubMed  CAS  Google Scholar 

  58. O’Dea M, Zincke H, Utz D, Bernatz P (1978) The treatment of renal cell carcinoma with solitary metastases. J Urol 120: 540

    PubMed  Google Scholar 

  59. Ortenberg J, Novick A, Stewart B (1982) Clinical problems involving the inferior vena cava. In: Novick A, Straffon R (eds) Vascular problems in urologic surgery. Saunders, Philadelphia

    Google Scholar 

  60. Penn J (1977) Transplantation in patients with primary renal malignancies. Transplantation 24: 424

    Article  PubMed  CAS  Google Scholar 

  61. Puigvert A (1976) Partial nephrectomy for renal tumour: 21 cases. Eur Urol 2: 70

    PubMed  CAS  Google Scholar 

  62. Rafla S (1970) Renal cell carcinoma. Cancer 25: 26

    Article  PubMed  CAS  Google Scholar 

  63. Robson C, Churchill B, Anderson W (1968) The result of radical nephrectomy for renal cell carcinoma. Am Assoc Genitourin Surg 60: 122

    CAS  Google Scholar 

  64. Robson C, Churchill B, Anderson W (1969) The results of radical nephrectomy for renal cell carcinoma. J Urol 101: 297

    PubMed  CAS  Google Scholar 

  65. Rosenthal C, Kraft R, Zingg E (1984) Organ-preserving surgery in renal cell carcinoma: tumor enucleation versus partial kidney resection. Eur Urol 10: 222

    PubMed  CAS  Google Scholar 

  66. Rosenthal D, Gershon C, Rudderman R (1985) Renal cell carcinoma invading the inferior vena cava: the use of the Greenfield filter to prevent tumor emboli during nephrectomy. J Urol 134: 126

    PubMed  CAS  Google Scholar 

  67. Schefft P, Novick A, Straffon R, Stewart B (1978) Surgery for renal cell carcinoma extending into the inferior vena cava. J Urol 120: 28

    PubMed  CAS  Google Scholar 

  68. Schiff M Jr, Bagley D, Lytton B (1979) Treatment of solitary and bilateral renal carcinoma. J Urol 121: 581

    PubMed  Google Scholar 

  69. Siminovitch J, Montie J, Straffon R (1982) Lymphadenectomy in renal adenocarcinoma. J Urol 127: 1090

    PubMed  CAS  Google Scholar 

  70. Skinner D, Colvin R, Vermillion C, Pfister R, Leadbetter W (1971) Diagnosis and management of renal cell carcinoma. A clinical and pathological study of 309 cases. Cancer 28: 1165

    Article  PubMed  CAS  Google Scholar 

  71. Skinner D, Pfister R, Colvin R (1972) Extension of renal cell carcinoma into the vena cava: the rationale for aggressive surgical management. J Urol 107: 711

    PubMed  CAS  Google Scholar 

  72. Smith R, de Kernion J, Ehrlich R, Skinner D, Kaufman J (1984) Bilateral renal cell carcinoma and renal cell carcinoma in the solitary kidney. J Urol 132: 450

    PubMed  CAS  Google Scholar 

  73. Sogani P, Herr H, Bains M, Whitmore W Jr (1983) Renal cell carcinoma extending into inferior vena cava. J Urol 130: 660

    PubMed  CAS  Google Scholar 

  74. Swanson D, Borges P (1983) Complications of transabdominal radical nephrectomy for renal cell carcinoma. J Urol 129: 704

    PubMed  CAS  Google Scholar 

  75. Swanson D, Johnson D, von Eschenbach A, Chuang V, Wallace S (1983) Angioinfarction plus nephrectomy for metastatic renal cell carcinoma — an update. J Urol 130: 449

    PubMed  CAS  Google Scholar 

  76. Tykka H, Oravisto K, Lehtonen T, Sarna S, Tallberg T (1978) Active specific immunotherapy of advanced renal cell carcinoma. Eur Urol 4: 250

    PubMed  CAS  Google Scholar 

  77. Waters W, Richie J (1979) Aggressive surgical approach to renal cell carcinoma: review of 130 cases. J Urol 122: 306

    PubMed  CAS  Google Scholar 

  78. Weigel J, Mebust W, Foret J, Noble M, Votapka T, Kirshnan E, Jewell W (1985) Treatment of renal cell carcinoma with renal infarction, delayed nephrectomy, medroxyprogesterone, and xenogenic immune RNA. Urology 15: 103

    Article  Google Scholar 

  79. Wickham J (1975) Conservative renal surgery for adenocarcinoma. The place of bench surgery. Br J Urol 47: 25

    Article  PubMed  CAS  Google Scholar 

Download references

Authors
  1. H. Behrendt
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Röntgendiagnostisches Zentralinstitut, Klinikum der Universität Essen, Hufelandstraße 55, D-4300, Essen, Germany

    Eberhard Löhr

  2. Institut für Pathologie, Klinikum der Universität Essen, Hufelandstraße 55, D-4300, Essen, Germany

    Lutz-Dietrich Leder

Rights and permissions

Reprints and permissions

Copyright information

© 1987 Springer-Verlag Berlin Heidelberg

About this chapter

Cite this chapter

Behrendt, H. (1987). Surgical Management of Renal Cell Carcinoma. In: Löhr, E., Leder, LD. (eds) Renal and Adrenal Tumors. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-71207-4_9

Download citation

  • DOI: https://doi.org/10.1007/978-3-642-71207-4_9

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-71209-8

  • Online ISBN: 978-3-642-71207-4

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics

Search

Navigation