Radical nephrectomy involves tying the renal artery and vein, removing the surrounding fibrous layer (called Gerota's fascia) and thereby completely excising the kidney, the surrounding fat, the adrenal gland, regional lymph nodes and the ureter.
A new surgical advance is removal of a kidney tumor by laparoscopic surgery. A small camera video system, suction instruments and electrosurgical instruments are inserted into the abdomen through small incisions. The whole kidney and lymph nodes are removed in a plastic sac. Although this technique is only for highly selected patients, it is much less invasive, since the whole abdomen is not opened. This permits a shortened hospital stay with more rapid convalescence and causes less patient discomfort.
Five-Year Survival 60 to 80 percent
Investigational None.
Stage II
TNM T3a, N0, M0
The tumor invades the surrounding fat or adrenal gland.
About 10 percent of cases are diagnosed in Stage II, and one-third of those patients will have micrometastases found at the time of surgery.
