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To the Editor: The review of renal cell carcinoma by Dr Curti¹ did not discuss nephron-sparing surgery (NSS) as an alternative to radical or laparoscopic nephrectomy. The risk of recurrence with NSS in appropriately sized tumors is less than 5%, which is equivalent to nephrectomy.^2-3 The risk of complications from NSS likewise is comparable with nephrectomy.^2-3 The benefit to the patient in terms of both preservation of renal function² and positive effect on patient quality of life⁴ has been well documented over the last decade. Indeed, NSS has been discussed as a possible standard of care for tumors less than 4 cm in diameter,⁵ and for appropriately selected patients this may be extended up to 7 cm in diameter.³ Given the evidence in favor of NSS for renal tumors less than 4 cm in size, a complete discussion of the current management of renal cell carcinoma should include NSS . . . [Full Text of this Article]

Jonathan C. Routh, MD
routh.jonathan@mayo.edu

Bradley C. Leibovich, MD; Horst Zincke, MD, PhD; Micheal L. Blute, MD
Department of Urology
Mayo Clinic
Rochester, Minn

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