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Advances in Urology
Volume 2010, Article ID 145942, 5 pages
http://dx.doi.org/10.1155/2010/145942
Clinical Study

Mini-Margin Nephron Sparing Surgery for Renal Cell Carcinoma 4 cm or Less

1Department of Urology, First Affiliated Hospital of Dalian Medical University, 222 zhongshan Road, Dalian 116011, China
2Department of Pathology, First Affiliated Hospital of Dalian Medical University, 222 zhongshan Road, Dalian 116011, China

Received 21 February 2010; Revised 18 May 2010; Accepted 9 July 2010

Academic Editor: Maxwell V. Meng

Copyright © 2010 Quanlin Li et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Objectives. To explore the safety and efficacy of mini-margin nephron sparing surgery (NSS) for renal cell carcinoma (RCC) 4 cm or less. Methods. Total of 389 cases of RCC 4 cm or less with normal contralateral kidneys were included in the study, including 135 cases treated by mini-margin NSS, 98 by 1 cm-NSS and 156 by radical nephrectomy (RN). The clinical results were followed-up and comparatively analyzed. Results. The mean and median margin width for mm-NSS was 2.2 and 2.0 mm (range 0 to 5). Of them, 112 (83.0%) cases had margins of 3 mm or less, and 26 had margins of 0 mm (19.3%). The mean width of margin for 1 cm-NSS was 11.6 mm (median 12, range 10 15). None of the NSS patients had positive surgical margins. The mean follow-up for mm-NSS, 1 cm-NSS and RN patients was 69, 82 and 82 months, respectively. Three mm-NSS patients, two 1 cm- NSS and four RN patients died of non-cancer related causes. Two mm-NSS patient (1.6%) experienced local recurrence. No distant metastasis was detected in all the patients. The over all 5-year survivals for NSS and RN patients were 100%, 100% and 98.7%, respectively ( ). Conclusions. Mini-margin NSS is as safe and effective as 1 cm-NSS and RN in treating early localized RCC 4 cm or less.