Urology

Renal Cancer Treatment

UrologyRenal Cancer

With the increasing popularity of health checks and body imaging, many cases of renal cancer can be detected at an early stage, where surgical resection has a cure rate exceeding 90%.

Surgical options include total nephrectomy or partial nephrectomy. Total nephrectomy involves the complete removal of the entire kidney along with the tumor, while partial nephrectomy involves removing only the tumor while preserving the remaining normal kidney tissue. Studies have found that if the renal tumor is 5 cm or smaller, total nephrectomy and partial nephrectomy have similar cure rates. Furthermore, partial nephrectomy allows for the preservation of more normal kidney tissue, reducing the chances of future chronic kidney failure and the need for dialysis, improving the long-term survival rates for patients.

(Principles of partial nephrectomy)

CUHK Medical Centre has acquired the latest software for 3D imaging reconstruction for partial nephrectomy. It enables precise analysis of renal vascular anatomy, tumor location and surrounding structures for improved surgical outcomes.

Renal Cancer Treatment Options

Minimally invasive laparoscopic surgery

Through a few small skin incisions on the abdomen the doctor completes the radical nephrectomy or partial nephrectomy procedure. Post-operative pain is minimised, and patient recovery is further enhanced.

Robotic assisted laparoscopic surgery

Suitable for partial nephrectomy for larger and more complex renal tumors. Robotic instruments are used for more precise tumor excision and haemostasis, reducing intra-operative blood loss and time of operation.

Open radical nephrectomy

If the tumor is too large, the physician will perform a radical nephrectomy using the conventional open surgical approach to completely excise the renal cancer.

Percutaneous tumor ablation

Can be used to treat small (less than 4 cm) renal tumor if the patient is not fit for operation. Commonly used percutaneous renal tumor ablation techniques include cryoablation and radiofrequency ablation.

Cryoablation

Cryoablation utilises argon-helium gas and the Joule Thomson effect to produce freezing and thawing effects within the tumor, hence killing tumor cells.

Radiofrequency ablation

In radiofrequency ablation, the fine needle put into tumor releases radiofrequency energy and generates heat energy within the planned treatment area, raising the temperature to over 60 degrees Celsius to achieve the effect of killing tumor cells.

Late Stage or Metastatic Renal Cancer

Postop recurrence rate for renal cell carcinoma with lymph node metastasis or high grade cancer is still relatively high. Apart from regular imaging surveillance, these types of high-risk patients can now undergo adjuvant immunotherapy to reduce the chance of recurrence.

As for late stage or metastatic renal cancer, conventional chemotherapy or target therapy are not sufficient for disease control. In recent years, newer combination therapy with PD-L1 inhibitors are bringing new hopes to suitable patients for improved survival outcomes.