OHSU

Surgical Treatment Options for Kidney Cancer

Most solid kidney tumors are found during examinations or tests for another medical condition. Most of these kidney tumors are cancerous, but many can be cured with surgery. Some kidney tumors are not cancerous, and cysts (fluid-filled tumors) can be malignant or benign. Imaging studies can tell your doctor whether a kidney tumor is cancer, but most solid tumors are cancerous and need to be removed.

There is a wide range of options for kidney cancer surgery.   These include:

  • Radical nephrectomy (removing the entire kidney)
  • Partial nephrectomy (removing just the cancerous part of the kidney)
  • Cryotherapy (freezing the tumor)
  • Radiofrequency ablation (heating the tumor)
  •  Stereotactic radiosurgery

Some tumors do not need treatment right away. Your doctor can examine you and do imaging studies at regular times to make sure the tumor is not getting worse. Some patients can also have chemotherapy instead of surgery, or after surgery, depending on the size of the tumor and how far it has spread.

Radical Nephrectomy

In this surgery, your doctor will remove the cancerous kidney, the  adrenal gland next to the kidney and the tissue around them.  This operation is used to treat for renal cell carcinomas larger than 4 centimeters. If you have this type of tumor, you will have a radical nephrectomy unless you have only one kidney, tumors in both kidneys or cannot survive with one kidney, or if you have a smaller tumors in the center of the kidney.

  • Your doctor can do an open (traditional incision) or minimally invasive surgery. Recovery after laparoscopic surgery is quicker. Your doctor will talk with you about the best procedure for you.
  • If the tumor has spread to other organs, such as the liver or spleen, your doctor may remove more tissue.
  • Your doctor may remove lymph nodes during surgery.
  • Larger kidney tumors may come back (recur) even after they are surgically removed. You may have chemotherapy after surgery to help prevent recurrence.

Partial Nephrectomy

Partial nephrectomy is removal of just the tumor, leaving the surrounding healthy kidney intact. If you have a renal cell carcinoma smaller than 4 centimeters or a larger tumors and medical conditions that could cause kidney failure, your doctor might do this surgery. You might also have a partial nephrectomy if you have only one kidney or tumors in both kidneys.

  • Your doctor can do an open (traditional incision) or minimally invasive surgery. Recovery after laparoscopic surgery is quicker. Your doctor will talk with you about the best procedure for you. .
  • Partial nephrectomy is more complicated than removing the entire kidney. We recommend working with a doctor and multidisciplinary care team that has experience with this type of surgery for kidney cancer.
  • An alternative to partial nephrectomy is freezing a tumor (cryotherapy) or heating the cancerous tissue to kill cancer cells (radiofrequency ablation or RFA). With these treatment options, the tumor is not removed.

Nephroureterectomy

In this surgery, your doctor will remove the cancerous kidney, the ureter and part of the bladder as well as the tissue around these organs. . 

  • Your doctor can do an open (traditional incision) or minimally invasive surgery.
  • Lymph nodes may also be removed. The bladder can also be removed, but this is rare.
  • Your doctor might remove only the ureter, leaving the kidney in place. 
  • Endoscopic surgery is removal of a a transitional cell cancer of the kidney or ureter through a telescope inserted through the urethra and into the bladder. This is a rare operation.
  • If the cancer has spread to tissue around the kidney or ureter or to other organs in the body, you might have chemotherapy in addition to surgery. 

Other Kidney Cancers

Other tumors can affect the kidneys. Renal sarcomas are treated with surgery. You might also have chemotherapy to treat a renal sarcoma.   Angiomyolipomas are tumors made of fat, muscle and blood vessels that can be treated with surgery, treatment to block the tumor’s blood supply or observation. Lymphomas are treated with chemotherapy. Oncocytomas are benign tumors that look like renal cell carcinomas. You might learn you have an oncocytoma after surgery to remove the tumor.