Conservative surgical treatment of renal cell carcinoma. The University of Miami experience.

Thirty-four patients with renal cell carcinoma underwent renal parenchymal-sparing surgery; 10 enucleation (Group A), 15 partial nephrectomy (Group B), and nine a combination of procedures (Group C). Conservative surgery was performed in the presence of normal contralateral unit in four patients (11.7%). Local recurrence (group A = 1, group B = 2, group C = 2) developed in five patients. Metastases appeared in six patients (17.6%) from 12 to 58 months postoperatively. Adequate renal function was obtained in 32 of the 34 patients. Mean follow-up for all patients was 64.6 months overall, 75.6 months from group A, 64.1 months for group B and 53.4 months for group C. The three and five year probabilities of survival for all patients were 77.8% and 69.5% respectively, 80% for group A, 80% for group B and 85% and 57.1% for group C. Enucleation and partial nephrectomy are both viable options in the management of solitary or bilateral renal cell carcinoma. There is no decline ineffective tumor control and prognosis.