What is the clinical significance of ipsilateral renal lesions during nephron-sparing surgery?
Paul L Crispen and Bradley C Leibovich*
Correspondence *Department of Urology, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA
Email leibovich.bradley@mayo.edu
This article has no abstract so we have provided the first paragraph of the full text.
While the indications for NSS are established as absolute, relative, and elective, the contraindications for NSS are not clearly defined. During the initial experience with NSS, large tumor size and unilateral multifocality were particularly concerning; however, with the proven oncologic efficacy and preservation of renal function provided by NSS, urologists have re-evaluated these relative contraindications.1, 2, 3 The incidence of multifocal RCC ranges from 5% to 25%;4 however, unlike tumor size, which can be effectively evaluated preoperatively, the majority of patients with multifocal disease are identified upon operative exploration or at the time of pathologic evaluation. Thus, given the relative infrequency of multifocal RCC and the timing of its detection, prospective evaluation of the role of NSS in the management of multifocal disease is difficult.
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