Top

Published in:

01-01-2019 | Nephrectomy | Kidney Diseases (G Ciancio, Section Editor)

Surgical Treatment of Completely Endophytic Renal Tumor: a Systematic Review

Authors: Javier Perez-Ardavin, Jose Vicente Sanchez-Gonzalez, Manuel Martinez-Sarmiento, Juan Jose Monserrat-Monfort, Jorge García-Olaverri, Francisco Boronat-Tormo, César D. Vera-Donoso

Published in: Current Urology Reports | Issue 1/2019

Abstract

Purpose of Review

An endophytic renal tumor represents a special surgical challenge in terms of location and safe removal. For this reason we wanted to review the existing literature on this subject.

Recent Findings

In high-activity robotic centers, robot-assisted partial nephrectomy (RAPN) is a safe and efficacious surgical approach for completely endophytic renal tumors. As research innovation, the application of the radio-guided occult lesion localization technique (ROLL) facilitates the location and complete excision of the tumor during surgery.

Summary

There are few studies that specifically report the experience with completely endophytic renal tumors. The endophytic tumor is usually smaller than exophytic. Frequently it represents a high complexity value in the different Score systems reported in the last decade. This surgery should be performed by experienced urologists regardless of the surgical approach they prefer (open, laparoscopic, or robotic). It is necessary to develop new techniques for intraoperative easy localization and intraoperative evaluation of surgical margins.

Siegel RL, Miller KD, Jemal A. Cancer statistics, 2018. CA Cancer J Clin. 2018;68(1):7–30. https://doi.org/10.3322/caac.21442.CrossRefPubMed

Hollingsworth JM, Miller DC, Daignault S, Hollenbeck BK. Rising incidence of small renal masses: a need to reassess treatment effect. J Natl Cancer Inst. 2006;98(18):1331–4. https://doi.org/10.1093/jnci/djj362.CrossRefPubMed

Johnson DC, Vukina J, Smith AB, Meyer AM, Wheeler SB, Kuo TM, et al. Preoperatively misclassified, surgically removed benign renal masses: a systematic review of surgical series and United States population level burden estimate. J Urol. 2015;193(1):30–5. https://doi.org/10.1016/j.juro.2014.07.102.CrossRefPubMed

Kane CJ, Mallin K, Ritchey J, Cooperberg MR, Carroll PR. Renal cell cancer stage migration: analysis of the National Cancer Data Base. Cancer. 2008;113(1):78–83. https://doi.org/10.1002/cncr.23518.CrossRefPubMed

Smaldone MC, Egleston B, Hollingsworth JM, Hollenbeck BK, Miller DC, Morgan TM, et al. Understanding treatment disconnect and mortality trends in renal cell carcinoma using tumor registry data. Med Care. 2017;55:398–404. https://doi.org/10.1097/MLR.0000000000000657.CrossRefPubMedPubMedCentral

Thompson RH, Kurta JM, Kaag M, Tickoo SK, Kundu S, Katz D, et al. Tumor size is associated with malignant potential in renal cell carcinoma cases. J Urol. 2009;181(5):2033–6. https://doi.org/10.1016/j.juro.2009.01.027.CrossRefPubMedPubMedCentral

Novick AC, Streem S, Montie JE, Pontes JE, Siegel S, Montague DK, et al. Conservative surgery for renal cell carcinoma: a single-center experience with 100 patients. J Urol. 1989;141(4):835–9.CrossRef

•• Kara O, Maurice MJ, Malkoc E, Ramirez D, Nelson RJ, Caputo PA, et al. Comparison of robot-assisted and open partial nephrectomy for completely endophytic renal tumours: a single centre experience. BJU Int. 2016;118(6):946–51. https://doi.org/10.1111/bju.13572 A big series showing similar results of open and robotic partial nephrectomy in endophytic tumors.CrossRefPubMed

• Autorino R, Khalifeh A, Laydner H, Samarasekera D, Rizkala E, Eyraud R, et al. Robot-assisted partial nephrectomy (RAPN) for completely endophytic renal masses: a single institution experience. BJU Int. 2014;113(5):762–8. https://doi.org/10.1111/bju.12455 First report of RAPN for endophytic renal tumors with an important number of patients.CrossRefPubMed

10.

Chung BI, Lee UJ, Kamoi K, Canes DA, Aron M, Gill IS. Laparoscopic partial nephrectomy for completely intraparenchymal tumors. J Urol. 2011;186(6):2182–7. https://doi.org/10.1016/j.juro.2011.07.106.CrossRefPubMed

11.

Betancourt Hernández JA, Vera Donoso C, Martinez-Sarmiento M, Monserrat JJ, Bello Jarque P, Boronat Tormo F. Application of the radio-guided occult lesion localization technique for renal lumpectomy: from the laboratory to the patient. Clin Nucl Med. 2017;42(11):e467–8. https://doi.org/10.1097/RLU.0000000000001811.CrossRefPubMed

12.

•• Harke NN, Mandel P, Witt JH, Wagner C, Panic A, Boy A, et al. Are there limits of robotic partial nephrectomy? TRIFECTA outcomes of open and robotic partial nephrectomy for completely endophytic renal tumors. J Surg Oncol. 2018;118(1):206–11. https://doi.org/10.1002/jso.25103 A big cohort encouraging open or robotic partial nephrectomy in endophytic tumors achieving good TRIFECTA criteria.CrossRefPubMed

13.

Di Pierro GB, Tartaglia N, Aresu L, Polara A, Cielo A, Cristini C, et al. Laparoscopic partial nephrectomy for endophytic hilar tumors: feasibility and outcomes. Eur J Surg Oncol. 2014;40(6):769–74. https://doi.org/10.1016/j.ejso.2013.11.023.CrossRefPubMed

14.

Zapala P, Dybowski B, Miazek N, Radziszewski P. Open partial nephrectomy for entirely intraparenchymal tumors: a matched case-control study of oncologic outcome and complication rate. Int Braz J Urol. 2017;43(2):209–15. https://doi.org/10.1590/S1677-5538.IBJU.2016.0040.CrossRefPubMedPubMedCentral

15.

Nadu A, Goldberg H, Lubin M, Baniel J. Laparoscopic partial nephrectomy (LPN) for totally intrarenal tumours. BJU Int. 2013;112(2):E82–6. https://doi.org/10.1111/bju.12168.CrossRefPubMed

16.

Weight CJ, Lane BR, Gill IS. Laparoscopic partial nephrectomy for selected central tumours: omitting the bolster. BJU Int. 2007;100(2):375–8.CrossRef

17.

Dall'Oglio MF, Ballarotti L, Passerotti CC, Paluello DV, Colombo JR Jr, Crippa A, et al. Anatrophic nephrotomy as nephron-sparing approach for complete removal of intraparenchymal renal tumors. Int Braz J Urol. 2012;38(3):356–61.CrossRef

18.

Komninos C, Shin TY, Tuliao P, Kim DK, Han WK, Chung BH, et al. Robotic partial nephrectomy for completely endophytic renal tumors: complications and functional and oncologic outcomes during a 4-year median period of follow-up. Urology. 2014;84(6):1367–73. https://doi.org/10.1016/j.urology.2014.08.012.CrossRefPubMed

19.

Mullerad M, Kastin A, Adusumilli PS, Moskovitz B, Sabo E, Nativ O. Comparison of nephron-sparing surgery in central versus peripheral renal tumors. Urology. 2005;65(3):467–72.CrossRef

20.

Black P, Filipas D, Fichtner J, Hohenfellner R, Thüroff JW. Nephron sparing surgery for central renal tumors: experience with 33 cases. J Urol. 2000;163(3):737–43.CrossRef

21.

Santos VE, Meduna RR, Bachega W Jr, Guimarães GC. Completely endophytic renal tumor: a laparoscopic approach. Int Braz J Urol. 2018;44:1050. https://doi.org/10.1590/S1677-5538.IBJU.2017.0534.CrossRefPubMedPubMedCentral

22.

Kutikov A, Uzzo RG. The R.E.N.A.L. nephrometry score: a comprehensive standardized system for quantitating renal tumor size, location and depth. J Urol. 2009;182(3):844–53. https://doi.org/10.1016/j.juro.2009.05.035.CrossRefPubMed

23.

Ficarra V, Novara G, Secco S, Macchi V, Porzionato A, De Caro R, et al. Preoperative aspects and dimensions used for an anatomical (PADUA) classification of renal tumours in patients who are candidates for nephron-sparing surgery. Eur Urol. 2009;56(5):786–93. https://doi.org/10.1016/j.eururo.2009.07.040.CrossRefPubMed

24.

• Mohapatra A, Potretzke AM, Weaver J, Anderson BG, Vetter J, Figenshau RS. Trends in the management of small renal masses: a survey of members of the Endourological Society. J Kidney Cancer VHL. 2017;4(3):10–9. https://doi.org/10.15586/jkcvhl.2017.82 eCollection 2017. This work shows the trends and evolution of surgical techniques among urologists in USA.CrossRefPubMedPubMedCentral

Title: Surgical Treatment of Completely Endophytic Renal Tumor: a Systematic Review
Authors: Javier Perez-Ardavin
Jose Vicente Sanchez-Gonzalez
Manuel Martinez-Sarmiento
Juan Jose Monserrat-Monfort
Jorge García-Olaverri
Francisco Boronat-Tormo
César D. Vera-Donoso
Publication date: 01-01-2019
Publisher: Springer US
Keywords: Nephrectomy
Renal Cancer
Nephrectomy
Nephrectomy
Published in: Current Urology Reports / Issue 1/2019
Print ISSN: 1527-2737
Electronic ISSN: 1534-6285
DOI: https://doi.org/10.1007/s11934-019-0864-x

ACC 2024 Congress

Springer Medicine

Surgical Treatment of Completely Endophytic Renal Tumor: a Systematic Review

Abstract

Purpose of Review

Recent Findings

Summary

ACC 2024 Congress

Springer Medicine

Abstract

Purpose of Review

Recent Findings

Summary

Please log in to get access to this content

Other articles of this Issue 1/2019

Imaging of Unusual Renal Tumors

A Critical Insight into the Clinical Translation of PD-1/PD-L1 Blockade Therapy in Clear Cell Renal Cell Carcinoma

Vascular Injury During Urologic Surgery: Somebody Call My Mother

Renal Medullary Carcinoma: a Report of the Current Literature

Use of Mannitol for Ischemia Reperfusion Injury in Kidney Transplant and Partial Nephrectomies—Review of Literature