신세포암 환자에서 부분 신절제술의 치료성적

Purpose: Although a radical nephrectomy is the mainstay in the surgical management of renal cell carcinomas, a partial nephrectomy is indicated in certain situations where a radical nephrectomy would render the patients in a state of renal insufficiency. Furthermore, the indications are being expanded to include incidentally found small unilateral renal cell carcinomas with a normal contralateral kidney. Therefore, the outcomes between patients treated with partial and radical nephrectomies for renal cell carcinomas were compared.<BR> Materials and Methods: Between January 1997 and March 2004, 171 nephrectomy operations were performed as curative treatments for renal masses at the urooncology department of our hospital. The study group was composed of 93 and 32 cases of radical and partial nephrectomies, respectively, with a final pathologic diagnosis of a renal cell carcinoma. The operations for renal cell carcinomas were performed by the same surgeon. The survival rate, time of local recurrence, complication and outcomes were compared and the records of 125 patients who underwent a nephrectomy for a renal cell carcinoma were retrospectively reviewed.<BR> Results: The overall mean postoperative follow-up was 25.9, ranging from 2 to 72 months. All the long-term outcomes of a partial nephrectomy for renal cell carcinoma were comparable to those of a radical nephrectomy, especially for localized renal cell carcinomas.<BR> Conclusions: A partial nephrectomy could be a better treatment option for localized renal cell carcinomas in appropriately selected cases with normal contralateral kidneys as well as in the absolute indication, with comparable outcomes to a radical nephrectomy, but the more groups and a long-term follow up are required if a partial nephrectomy is to become the standard operation for localized renal cell carcinoma treatment.