PURPOSE: @entity1 with @entity280 frequently have early, multiple and recurrent @entity1358 . @entity1358 treatment, which must prevent @entity3 and spare nephrons, has changed in the last 2 decades. We evaluated @entity1358 treatments in the long term in a large series of @entity1 with @entity280 . MATERIALS AND METHODS: We retrospectively evaluated the use and results of surgery and radio frequency ablation in @entity1 with @entity280 followed at our institution between 1988 and 2009. Renal anatomical survival was analyzed according to 3 periods, including 1) 1988 to 1994--the learning phase of nephron sparing surgery, 2) 1995 to 2003--routine nephron sparing surgery and 3) 2004 to 2009--the emergence of radio frequency ablation. RESULTS: A first @entity1358 was treated at a mean age of 38 years (range 15 to 67) in 113 @entity1 with @entity280 . During a median followup of 7.2 years 251 therapeutic procedures were performed in a total of 176 kidneys. We observed a shift of first @entity1358 treatment with time, that is nephrectomy in 52% of cases in period 1, tumorectomy in 75% in @entity5394 and radio frequency ablation in 43% in @entity5395 . The shift paralleled improved renal survival. While nephron sparing surgery was primarily done for lesions greater than 30 mm, radio frequency ablation was used to treat less numerous and smaller ipsilateral lesions but they required more frequent intervention. Radio frequency ablation became the most widely used second or third line procedure and allowed renal salvage in 8 @entity1 . CONCLUSIONS: Nephron sparing surgery and more recently radio frequency ablation enable earlier treatment of @entity5 and are associated with a significant improved renal prognosis in @entity1 with @entity280 .

Progress in nephron sparing therapy for XXXX and @entity280 .

@entity1 :: ('9606', 'Species') :: ['Patients', 'patients'] @entity5394 :: ('8864', 'Gene') :: ['period 2'] @entity5 :: ('MESH:D009369', 'Disease') :: ['smaller tumors'] @entity5395 :: ('8863', 'Gene') :: ['period 3'] @entity1358 :: ('MESH:D002292', 'Disease') :: ['renal cell carcinoma', 'line renal cell carcinoma', 'Renal cell carcinoma'] @entity3 :: ('MESH:D009362', 'Disease') :: ['metastatic disease'] @entity280 :: ('MESH:D006623', 'Disease') :: ['von Hippel-Lindau', 'von Hippel-Lindau disease']
@entity1358 :: (MESH:D002292,Disease) :: ['renal cell carcinoma']
