The Diagnosis And Treatment Of Small Renal Cell Carcinoma

Objective To investigate the diagnosis and treatment of small renal cell carcinoma (SRCC) with a diameter less than 4cm.Methods 46 cases of SRCC were reviewed. The results of medical imaging diagnosis were compared. These cases were categorized as Radical nephrectomy (RN) or Nephron sparing surgery(NSS) cases according to different surgery therapy, and follow-up study of the effectiveness of these treatments was undertaken.Result All the 46 cases had only one tumor in one kidney with a mean tumor diameter of 2.85±0.80cm. B-ultrasonography and CT scanning were conducted for all cases, with the diagnosis rate of 87% and 95.7%.And the diagnosis rate of MRI was 81.3%(13/16).1 cases received examination of DSA and were diagnosed as SRCC. ECT and IVU were not important for the diagnosis. All cases received surgery. RN was performed for 20 cases and NSS was undertaken for 26 cases. The excised tumors were pathologically confirmed to be clear cell carcinoma with the tumor stage at T1aN0M0.All cases that were treated by RN surgery have been followed up with a mean period of 46.2 months, and 26 cases that were treated with NSS surgery have been followed up with a mean period of 45.6 months. All the 46 cases survive so far.ConclusionThe diagnosis of SRCC mainly depends on the medical imaging. B-ultrasonography is the main method of diagnosis.CT and MRI are the most valuable examination methods with high accuracy.RN is effective and safe for the treatment of SRCC. But with the development of medical imaging and Surgical Technology, and the satisfactory long-term survival rate, NSS for SRCC is considered more and more valuable in clinic. Currently, NSS by laparoscopy is being applied in more and more urology centers for the treatment of SRCC.