Treatment of Stage I Kidney (Renal Cell) Cancer

This content has been reviewed and approved by

Robert J. Motzer, MD
Attending Physician

Memorial Sloan-Kettering Cancer Center

Patients who have stage I renal cell cancer have a relatively small tumor. By definition, the tumor is 7 centimeters (about 3 inches) or less in size. The cancer is only in the kidney, not in the lymph nodes or other organs.

Stage I renal cell cancer is curable if your doctor removes the cancer surgically. Nephrectomy (surgical removal of the kidney) is associated with a 90 percent or higher cure rate.

A radical nephrectomy is the removal of the entire kidney and the fatty tissue immediately surrounding the kidney. It may also mean removing the nearby adrenal gland, although many surgeons today avoid this if possible. The "gold standard" for treating stage I renal cell cancer is radical nephrectomy.

A partial nephrectomy is a procedure that involves removing only the part of the kidney with cancer. Doctors often recommend partial nephrectomy when appropriate. The reasoning is that sparing normal tissue in the involved kidney(s) may help preserve the body's kidney function.

Partial Nephrectomy

There have been several studies suggesting that long-term kidney function is better in patients undergoing partial versus radical nephrectomy. Many studies show that partial nephrectomy is as effective as radical nephrectomy and may have fewer long-term serious side effects.

There is general agreement that managing cancers less than 4 centimeters (less than 1½ inches) with partial nephrectomy is acceptable. Patients with cancers between 4 and 7 centimeters are more likely to have a radical nephrectomy.

Partial nephrectomy may be recommended to patients if the cancer involves both kidneys, if only one kidney is present, or if kidney function is too poor to risk losing an entire kidney. Partial nephrectomy has also been used to treat patients with small cancers in one kidney, even if the other kidney is normal. Research is ongoing to determine the best treatment options.

Laparoscopic Nephrectomy

Recently, surgeons have been performing nephrectomy as a laparoscopic procedure. Laparoscopic nephrectomy is performed using small incisions (surgical cuts). The surgeon removes the kidney through these incisions, with the help of a tiny camera attached to the end of a thin tube for viewing within the body. This helps the patient recover from the surgery more quickly and with less pain.

Your surgeon will recommend the procedure that he or she believes is best for your individual situation. Remember that it is important for both you and your surgeon to be comfortable with the procedure chosen to maximize the likelihood of success and minimize any potential risks.

For information on some of the techniques currently under investigation, see Strategies to Improve Treatment.