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NCCN Guidelines for Patients



Kidney Cancer, Version 1.2017


Overview of cancer treatments


There is more than one treatment for

kidney cancer. The main types are

described on the next pages. This

information may help you use the

Treatment guide in Part 5. It may also help

you know what to expect during treatment.

Not every person with kidney cancer will

receive every treatment listed.


Surgery is an operation to remove or repair a body

part. Surgery is used as primary treatment for most

kidney cancers. Primary treatment is the main

treatment given to rid the body of cancer. Thus, the

goal of surgery is to remove all of the cancer from

your body. To do so, surgery will remove all or part

of the kidney with the tumor and maybe other nearby


There is more than one type of surgery for kidney

cancer. The type and extent of surgery you will have

depends on many factors. This includes the tumor

size, tumor location, and how much the cancer has

spread. The main types of surgery used to treat

kidney cancer are described next.

Partial nephrectomy

A partial nephrectomy is surgery that only removes

the part of the kidney with the tumor. With this

surgery, the healthy part of your kidney and the

nearby tissues are left in your body. It is also called

nephron-sparing or kidney-sparing surgery since it

saves (spares) as much of your kidney as possible.

The kidney can still work (function) and do its job in

the body after part of it has been removed. Thus,

a benefit of partial nephrectomy is that it preserves

kidney function. This surgery is ideal for patients

who have or are at risk for poor kidney function. This

includes patients who have only one kidney, limited

kidney function, or tumors in both kidneys. But, this

surgery is used for other patients as well.

Partial nephrectomy is often used for early-stage

kidney cancer—when the tumor is small and only in

the kidney. This surgery is the preferred treatment for

very small tumors no more than 4 cm wide. It may

also be used to treat small tumors up to 7 cm wide.

For most small tumors, a partial nephrectomy can

remove all the cancer with good long-term results.

But, the surgeon’s skill and experience is a key


Partial nephrectomy is a complex surgery. It is more

technically difficult than surgery that removes the

whole kidney. A partial nephrectomy should only be

done by an expert surgeon who does this type of

surgery often. Careful patient selection, based on

factors such as the tumor size and location, is also

important. This surgery should only be done when

the entire tumor can be safely removed, leaving the

healthy part of the kidney intact.

Before the surgery, you will be asked to stop eating,

drinking, and taking some medicines for a short

period of time. If you smoke, it is important to stop.

This surgery is done under general anesthesia—a

controlled loss of wakefulness from drugs. There is

more than one way to perform a partial nephrectomy.

The surgery methods that may be used are

described on page 31.

Risks and side effects of partial nephrectomy

With any type of surgery, there are some health

risks and side effects. A side effect is an unhealthy

or unpleasant condition caused by treatment. Some

possible side effects of a partial nephrectomy include

infections, bleeding, pain from the surgical cuts, and

urine leaking from the kidney.