Zhang X, Su Z, Lv P, et al. - Nephron-sparing surgery (NSS) for localized renal cell carcinoma (RCC) provides better preservation of renal function and oncological outcomes than radical nephrectomy (RN), with acceptable complications. These results may help enhance clinical decision making for localized RCC cases with high anatomical complexity.

• In this analysis of 575 participants, experts sought to compare NSS vs RN in patients with localized RCC with high anatomical complexity Radius, Exophytic/endophytic, Nearness, Anterior/posterior, Location. (R.E.N.A.L.) score ≥10.

• In the matched group, there was lower estimated glomerular filtration rate loss in relation to NSS vs the RN group (17.81 mL/min/1.73 m ² vs 28.28 mL/min/1.73 m ² ).

• NSS provided better recurrence-free survival, cardiocerebrovascular disease-specific survival and overall survival than RN.

• No difference in cancer-specific survival was found between both groups.

• Also, incidence of minor and major complications did not differ in the two groups.