Abstract
The standard of care treatment for solitary renal cell carcinoma (RCC) tumors 4 cm or less is partial nephrectomy (PNx). However, multifocal kidney cancer presents unique challenges for treating physicians. Historically, total nephrectomy and hemodialysis with possible renal transplant later was the primary therapeutic strategy for these patients. Later, as nephron sparing surgical approaches improved, PNx became the standard of care for patients presenting with multifocal and hereditary RCC. Surgeries to remove multiple renal tumors simultaneously produce different perioperative outcomes and increased risk of complications. Due to these differences in technique and outcomes, the term multiplex partial nephrectomy (MxPNx) has been coined to designate these differences. Here, we discuss the role that MxPNx continues to play in multifocal RCC.
Highlights
Reviewed by: Jianbo Li, Cleveland Clinic Lerner College of Medicine, United States Sanja Štifter, University of Rijeka, Croatia
The subset of multifocal and hereditary renal cell carcinoma (RCC) patients who do require repeat renal surgery (RRS) and salvage renal surgery (SRS) tend to undergo these procedures at average intervals greater than 5 years while enduring complication rates greater than 50% [10]
Other reports suggest that renal allograft halflife may be as long as 16 years in some patient populations [14]. These results suggest that the ongoing improvements in immunosuppression and allograft survival may make this approach a more appealing strategy for patients with multifocal and hereditary RCC
Summary
Reviewed by: Jianbo Li, Cleveland Clinic Lerner College of Medicine, United States Sanja Štifter, University of Rijeka, Croatia. As nephron sparing surgical approaches improved, PNx became the standard of care for patients presenting with multifocal and hereditary RCC.
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