Cared for by Dr Dimitri Gambachidze
Most kidney tumours are found incidentally on a scan performed for another reason, at a small and curable stage. The guiding principle of the practice is nephron sparing: whenever it is oncologically safe, only the tumour is removed and the rest of the kidney preserved, because long-term renal function matters for cardiovascular health and life expectancy. Robotic assistance makes precise tumour excision and rapid reconstruction possible even for tumours in difficult locations.
The tumour is removed with a margin of healthy tissue and the kidney reconstructed, keeping ischaemia time to a minimum. It gives the same cancer control as removing the whole kidney while preserving renal function.
For large, central or locally advanced tumours, the whole kidney is removed, robotically or laparoscopically whenever feasible, with lymph node dissection when indicated.
Small renal masses in older or comorbid patients can be monitored with imaging, or treated by radiofrequency or cryoablation in coordination with interventional radiology.
Locally advanced or metastatic disease is managed with the medical oncology team, combining systemic therapy with surgery when it is of benefit.
In the great majority of small and intermediate tumours, yes. The decision depends on size, position and the anatomy shown by the CT, which is reviewed with you image by image.
Nephron-sparing surgery becomes even more important, and the operation is planned with particular attention to ischaemia time and reconstruction.
Not always. It is useful for small masses when the result could change the plan, for example towards surveillance or ablation.