Renal cell carcinoma is the most common cancer of the kidneys that is primarily treated with surgery, including removal of part or all the involved kidney depending on size and tumor, complexity, and patient characteristics. Partial nephrectomy historically was restricted to cases of solitary kidney or bilateral tumors. It was then started for masses smaller than 4 cm and currently is even studied and justified in tumors smaller than 7 cm if surgically feasible. Although partial nephrectomy preserves kidney tissue and, therefore, delays or prevents the new onset of CKD and ESRD, radical nephrectomy is still overused even for the small tumors. Studies have shown that although this practice is driven by an easier complete removal of the kidney especially in the era of minimally invasive surgery, partial nephrectomy is successful in curing cancer and achieving excellent cancer-specific survival in addition to its benefits on cardiovascular health. Nowadays interest in preserving healthy kidney tissue is increasing to the level of studying the impact of larger volume removed around the kidney and the histopathology of that non-neoplastic tissue to predict kidney function behavior postoperatively.
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Can parenchymal volume analysis replace nuclear renal scans for split renal function before and after partial nephrectomy with warm ischemia?
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Department of Urology, Sun Yat-sen University Cancer Center, Guangzhou, P. R. China; State Key Laboratory of Oncology in Southern China; Collaborative Innovation Center for Cancer Medicine, Guangzhou, China; State Key Laboratory of Oncology in Southern China, Guangzhou, P. R. China. Electronic address:
Article Synopsis
- The study evaluates parenchymal volume analysis (PVA) as a potential alternative to nuclear renal scan (NRS) for assessing split renal function (SRF) before and after partial nephrectomy (PN) with warm ischemia.
- Preoperatively, PVA showed a strong correlation with NRS findings, indicating its reliability for SRF assessment (49.4% vs. 50.0%, P = .501).
- Results suggest that while PVA is consistent with NRS preoperatively, the efficacy of PVA remains uncertain for post-operative SRF evaluation after PN, indicating a need for further investigation.
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