What Are the Surgical Options for Kidney Cancer?

Surgery is the main treatment for most kidney cancers, especially when the tumor is confined to the kidney. The goal is to remove the cancer while preserving as much kidney function as possible. The type of surgery depends on the size, location, and stage of the tumor, as well as the patient’s overall health.

Partial Nephrectomy (Kidney-Sparing Surgery)

In a partial nephrectomy, only the tumor and a small margin of surrounding healthy tissue are removed. The rest of the kidney is preserved. This option is usually recommended for:

• Tumors smaller than 4 cm (about 1.6 inches)
• Tumors located away from major blood vessels or the collecting system
• Patients with only one kidney or reduced kidney function

It can be done through open surgery, laparoscopic surgery, or robot-assisted techniques, depending on the surgeon's expertise and the tumor's complexity.

Radical Nephrectomy

A radical nephrectomy involves removal of the entire kidney, often along with the surrounding fat, adrenal gland (if necessary), and nearby lymph nodes. This is generally recommended for:

• Larger tumors
• Tumors that involve the central part of the kidney
• Tumors that have spread locally but not to distant organs

This surgery can also be performed using open, laparoscopic, or robotic methods.

Cytoreductive Nephrectomy

In advanced kidney cancer that has spread to other organs (stage 4), removing the kidney may still be helpful to reduce tumor burden and improve outcomes when combined with systemic treatments like immunotherapy.

Minimally Invasive Techniques

In some cases, tumor ablation (using heat or cold to destroy the tumor) may be used, especially for patients who cannot undergo surgery. However, these are less common and generally reserved for small tumors.

Surgical choice is tailored to each patient. Kidney-sparing approaches are preferred when possible to preserve long-term kidney health.

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