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Minimally Invasive Treatment of Renal Cancer by Dr. Álvaro Sarkis

Explore minimally invasive treatments for renal cancer by renowned urologist, Dr. Álvaro Sarkis. Comparison of laparoscopic nephrectomy and open surgery, cryoablation vs. partial nephrectomy for small renal tumors, and functional & oncological outcomes of nephron-sparing surgery for larger tumors. Stay up to date with the latest advancements in renal cancer treatments.

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Minimally Invasive Treatment of Renal Cancer by Dr. Álvaro Sarkis

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  1. Upto DateCâncer de rim tratamento minimamente invasivo Álvaro Sarkis Professor Livre Docente Universidade de São Paulo Urologista do Hospital do Servidor Público de São Paulo

  2. Outline • Nefrectomiaminimamenteinvasivavsabertaparatumores 4cm a 7cm • Crioablaçãolaparoscópicavs PN paratumoresrenaispequenos: revisãosistemática • Evoluçãofuncional e oncológica de NSS paratumoresrenais >7 cm

  3. Nefrectomiaminimamenteinvasivavsabertaparatumores 4cm a 7cm

  4. MSKCC N=280 de 2290

  5. Seguimentolivre de recidivas e metástases Mediana de follow-up para OPN 29 meses e MIPN 13 mo, Seguimentocurtoi!! EUROPEAN UROLOGY 61 (2012) 593–599

  6. NefrectomiaparcialparaTumores > 4 cm EUROPEAN UROLOGY 61 (2012) 593–599

  7. 9()% das nefrectomiasnãosãoparciais EUROPEAN UROLOGY 61 (2012) 593–599

  8. Conclusão • LPN podeserfeita com segurançaemtumores > 4 a 7cm, com aumento de morbidade (fistula 7% laparoscopiavs 5% aberta)

  9. Crioablaçãolaparoscópicavs PN paratumoresrenaispequenosrevisãosistemática

  10. EUROPEAN UROLOGY 60 (2011) 435–443

  11. EUROPEAN UROLOGY 60 (2011) 435–443

  12. Crioablaçãolaparoscópicavs PN paratumoresrenaispequenos EUROPEAN UROLOGY 60 (2011) 435–443

  13. Crioablação laparoscópica vs PN para tumores renais pequenos EUROPEAN UROLOGY 60 (2011) 435–443

  14. Conclusões • LCA e PN sãoopçõesviáveispara o tratamento de SRMs • LCA tem maiorrisco de progressão local • PN é "gold standard"

  15. Evoluçãofuncional e oncológica de NSS paratumoresrenais >7 cm

  16. 5767 patients were treated for renal tumours at two institutions from 1984 to 2009. In 91 patients, elective NSS was performed for renal tumours> 7 cm. The median follow-up was 28 mo (range: 1–247 mo). Twenty- seven patients (29.6%)

  17. Comparavelàcirurgiaaberta

  18. Conclusão • NSS paratumoresrenais > 7cm éviavel e podesersemprefeitadesdequetecnicamentefactível* *proposta dos autores

  19. Conclusõesgerais • LPN podeserfeita com segurançaemtumores > 4 a 7cm, com aumento de morbidade (fistula 7% lap. vs 5% aberta) • LCA e PN sãoopçõesviáveispara o tratamento de SRMs • LCA tem maiorrisco de progressão local • PN é "gold standard” • NSS paratumoresrenais > 7cm éviavel e podesersemprefeitadesdequetecnicamentefactível

  20. n addition to a comparable oncological outcome be- tween NSS and RN for renal tumors larger than 4 cm, we have shown that increasing age, ASA score 3􏰄4, preop- erativeeGFR, and RN are associated with the develop- ment of CKD in a balanced cohort for patients treated by NSS or RN for renal tumors 􏰆4 cm. NSS maintains renal function with comparable perioperative morbidity to RN. It is therefore reasonable to postulate that NSS should be performed, whenever technically feasible.

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