Editorial Comment

Abstract

The selection of patients for either partial or radical nephrectomy remains a clinical challenge. Today, there is significant attention placed on the promise of personalized medicine—tailoring the treatment of a condition to an individual patient. Although modern personalized medicine efforts typically rely on genetic profiling of tumors, urologists have always delivered “personalized” care. For patients with a small renal mass amenable to partial or radical nephrectomy, the initial consultation, conversation, and physical examination provide “clinical phenotypes” that we use to select the best surgical approach (eg, the patient's overall physical health, frailty, distress, and body habitus). We glean additional “parameters” from the health record (eg, comorbidity and renal function) and imaging studies (eg, tumor location and size). This selection process is also influenced by our own prior successes and complications, and our comfort with various surgical procedures.