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In Reply: Organ preservation and the use of less invasive surgical techniques have become commonplace in the initial management of patients with cancer. Examples include lumpectomy as an alternative to mastectomy in breast cancer,¹ and limb-sparing surgery instead of amputation in extremity sarcomas.² Dr Routh and colleagues review data from several retrospective studies using NSS instead of radical nephrectomy for early-stage renal cell carcinoma. They conclude that NSS is an appropriate therapeutic option for selected patients with survival and complication rates similar to radical nephrectomy.

The extant retrospective data regarding NSS support their conclusions. Retrospective studies using laparoscopic NSS also exist with results similar to open NSS.³ However, there are no randomized data comparing NSS with radical nephrectomy. In the absence of such confirmatory data, it is reasonable to present NSS as a surgical alternative to radical nephrectomy for early-stage patients with renal cancer at centers with expertise in these . . . [Full Text of this Article]

Brendan D. Curti, MD
brendan.curti@providence.org
Robert W. Franz Cancer Research Center
Earle A. Chiles Research Institute
Providence Portland Medical Center
Portland, Ore

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Nephron-Sparing Surgery and Renal Cell Carcinoma
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