Kidney Cancer

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Surgical Treatment Overview

Surgical Treatment of Kidney Cancers

 

Surgery is the main treatment for kidney cancers.

 

Radical Nephrectomy

  • This involves removal of the entire kidney, the adjoining adrenal gland, and the surrounding fatty tissue (all contained within Gerota’s Fascia). This operation is used for renal cell carcinomas that are larger than 4cm or for smaller tumors if they are located in the center of the kidney.
  • Radical nephrectomies are performed in a laparoscopic (minimally-invasive) manner unless the tumor is too large or invades surrounding organs.
  • If the tumor invades surrounding organs (such as the liver or spleen) or is involving the inferior vena cava, these structures may be removed in addition to the kidney. Depending upon the location and extent of such locally-advanced disease, open or laparoscopic techniques may be used.
  • Larger kidney tumors may recur even after complete surgical removal. Therefore, drug (medical therapy) may be given after surgery to help prevent recurrence. This treatment usually involves stimulation of the immune system and is called systemic immunotherapy.


Partial Nephrectomy and Nephron-sparing Surgery

  • This involves removal of the tumor, leaving the surrounding normal kidney tissue intact. This operation is often used for renal cell carcinomas that are smaller than 4cm or for larger tumors if a patient has or is at risk for kidney failure (such as severe high blood pressure, kidney stones, diabetes).
  • Sometimes, the tumor can be frozen, a process known as cryotherapy. In this case, no tissue is removed and the cancer cells are killed by freezing them.
  • Partial nephrectomies are performed in a laparoscopic (minimally-invasive) manner unless the tumor is centrally located. Cryotherapy is usually performed through a laparoscopic approach.
  • Surgeons at the University of Chicago are trained in the most up-to-date and technologically-advanced methods of treating kidney cancers and saving normal kidney tissue.
     

Nephroureterectomy

  • This involves removal of the kidney, the ureter, and all of the surrounding tissue. This operation is often used for transitional cell cancers of the kidney and ureters.
  • Nephroureterectomies and ureterectomies are performed in a laparoscopic (minimally-invasive) manner unless the tumor is invading surrounding organs.
     

Ureterectomy

  • This involves removal of all or part of the ureter, leaving the kidney intact. This operation is infrequently used and applies to patients with small, early cancers and poor kidney function.
  • Reconstruction of the ureter may be necessary, which may involve a direct reconnection of the normal edges, reshaping the bladder to form into a tube, or placing a piece of intestine between the kidney and bladder.
  • Ureterectomies can be performed in an open or laparoscopic (minimally-invasive) manner.
     

Endoscopic Kidney Surgery

  • This involves removing a transitional cell cancer of the kidney or ureter through a telescope inserted through the urethra and into the bladder.
  • This operation is reserved for ill patients and those with very small, superficial, and non-aggressive tumors.

Surgeons at the University of Chicago are trained in the most up-to-date and technologically-advanced methods of treating kidney cancers. At you appointment, your surgeon will be glad to discuss all of these treatment options with you, as well as any applicable clinical trial or experimental therapy.