Novick Andrew C
The Cleveland Clinic Foundation, Urological Institute, 9500 Euclid Avenue, Cleveland, Ohio 44195, USA.
Annu Rev Med. 2002;53:393-407. doi: 10.1146/annurev.med.53.082901.103937.
Nephron-sparing surgery (NSS) provides effective curative therapy for patients with localized renal cell carcinoma. In patients with imperative indications, it represents an alternative to renal replacement therapy. For selected patients with systemic comorbidities that threaten global renal function, NSS preserves unaffected nephrons with excellent cancer-specific survival. Elective partial nephrectomy for patients with a small (< or = 4 cm), unifocal tumor and a normal contralateral kidney is associated with a low risk (0%-3%) of local recurrence and cancer-specific survival rates of 90%-100%. Comparisons between radical and partial nephrectomy demonstrate equivalent cancer control over five years. Minimally invasive techniques of NSS are feasible but await improved technologies and long-term outcome data before they become fully acceptable treatment options.
保留肾单位手术（NSS）为局限性肾细胞癌患者提供了有效的治愈性治疗。对于有迫切指征的患者，它是肾脏替代治疗的一种替代方法。对于患有威胁整体肾功能的全身性合并症的特定患者，NSS可保留未受影响的肾单位，并具有出色的癌症特异性生存率。对于肿瘤小（≤4 cm）、单灶且对侧肾脏正常的患者进行择期部分肾切除术，局部复发风险低（0%-3%），癌症特异性生存率为90%-100%。根治性肾切除术和部分肾切除术的五年癌症控制效果相当。NSS的微创技术是可行的，但在成为完全可接受的治疗选择之前，还需要改进技术和长期结果数据。
