Abstract
Surgery is the only treatment modality that offers a cure for kidney cancer. Increasing use of imaging in all branches of medicine (particularly ultrasound) has detected a large number of smaller solid renal lesions. Their nature may be uncertain and a proportion are benign. These incidental findings present difficult management problems for uro-oncology MDTs – the options are: to watch and wait, to biopsy, to excise locally [partial or nephron sparing surgery] or to undertake total nephrectomy. There is no clear answer for the smaller renal mass. The role of biopsy before surgery remains contentious and more complex radiological techniques do not often lead to a clearer diagnosis. Emphasis must be on adequate treatment for suspected cancer rather than technique, but partial nephrectomy is a proper, safe technique which preserves nephrons and has a low rate of local recurrence. The arguments for and against are well laid out in the following articles. Derek Fawcett Consultant Urological Surgeon, Royal Berkshire Hospital, Reading, UK; E: dpfawcett@msn.com
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