Kidney Cancer

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Surgery

Surgery is the most common treatment for kidney cancer that has not spread outside of the kidney. There are several different surgical procedures your doctor may use to treat your cancer, depending on the type, size and location of the tumor, the extent of your cancer, and your overall health and physical condition.
 

Renal Cell Carcinoma

For renal cell carcinoma, the surgery choices range from removing part of the kidney to all of it. Options include the following:

  • Radical nephrectomy. The entire kidney is removed, including the tumor and a border of healthy tissue and nearby lymph nodes.       
  • Partial nephrectomy. Only the part of the kidney that contains the cancer and a small margin of healthy tissue around it is removed, leaving the rest of the healthy kidney behind.
  • Regional lymphadenectomy. The nearby lymph nodes are removed to see if they contain cancer.
  • Arterial embolization. This procedure shrinks the tumor by depriving it of oxygen-carrying blood and other substances. It is sometimes used before surgery to make surgery easier, especially in patients who have a tumor thrombus--a clot of tumor that extends into the renal vein or inferior vena cava (the main vein returning blood back to the heart).

Laparoscopic or Robotic Surgery

Whenever possible, based on the size of the tumor and certain patient characteristics such as prior surgeries, our doctors perform radical and partial nephrectomies with laparoscopic or robotic surgery techniques. These involve making small keyhole incisions on the abdomen and using long telescopic instruments to perform the surgery.

Ablation (Cryotherapy or Radiofrequency Ablation)

Ablation techniques treat kidney cancers by using extreme temperatures to kill the cancers. The two most common techniques are cryotherapy to freeze the tumor and radiofrequency ablation to overheat the tumor. These technologies can be delivered to the tumor percutaneously, meaning that small punctures are made in the skin and a needle is guided to the tumor for delivery of the cryo- or radiofrequency ablation. They can also be delivered under direct visual guidance by laparoscopically exposing the kidney. Ablation is used to treat small kidney tumors.

Urothelial Carcinoma of the Kidney

Urothelial carcinoma is a cancer that grows off the lining or renal pelvis of the kidney. These cancers are more closely related to bladder cancer than they are to kidney cancer. Surgical treatment options include the following:
  • Nephroureterectomy. The entire kidney is removed including the tumor and a border of healthy tissue and nearby lymph nodes. The entire ureter is also removed all the way down to the bladder where a small part of the bladder surrounding the ureter is also removed.
  • Endoscopic resection. A small telescope is passed up to the ureter and kidney and an electric current or a narrow beam of intense laser light is used to remove cancer cells by burning away the tumor and the areas around it.

Depending on the size of the tumor and the appearance of the affected kidney, we sometimes recommend chemotherapy before removing the kidney and the ureter.

Surgery Risks

Risks of surgery include bleeding during or after surgery that may require blood transfusions; wound infection; damage to internal organs and blood vessels during surgery; unwanted air in the chest cavity; hernia near the incision; and kidney failure if the remaining kidney fails to function well. Some of these risks are lessened with laparoscopic or robotic surgery including a lower risk of wound complications like infection or hernia.