Treatment of Stage II Kidney (Renal Cell) Cancer

This content has been reviewed and approved by

Robert J. Motzer, MD
Attending Physician

Memorial Sloan-Kettering Cancer Center

Patients with stage II renal cell cancer have a primary cancer (original tumor) that is larger than 7 centimeters (about 3 inches). In this stage, the cancer is only in the kidney, and there is no spread to lymph nodes (little filters, scattered throughout the body, that help destroy bacteria and viruses) or distant sites.

Stage II renal cell cancer is curable if your doctor removes the cancer through a procedure called a nephrectomy (surgical removal of the kidney). Radical nephrectomy is the most common treatment for stage II kidney cell cancer and has a 65 percent to 70 percent cure rate.

A radical nephrectomy involves removing the entire kidney and the fatty tissue immediately surrounding the kidney. It may also include removal of the nearby adrenal gland, although many surgeons now avoid this when possible. Surgical complications occur in approximately 3 percent of patients. If treatment should fail, the major reason is metastatic renal cell cancer (cancer that spreads outside the primary tumor site).

A nephrectomy may be performed as a traditional open operation or as a laparoscopic-directed operation. An open nephrectomy is a nephrectomy that is performed through a traditional incision (surgical cut). This exposes the kidney and allows the surgeon to see and manipulate it without special instruments.

A laparoscopic nephrectomy is a nephrectomy that is performed using much smaller incisions. Laparoscopic surgery does not expose the kidney as much as traditional surgery, or involve as much manipulation of body tissues. For this reason, patients have less pain and need less time to heal after laparoscopic nephrectomy compared with traditional surgery.

Depending on the size of the cancer and the preferences of the surgeon and patient, stage II renal cell cancer may be treated with open or laparoscopic-directed nephrectomy. Remember that it is important for 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.