Partial nephrectomy is the gold standard surgical treatment for kidney cancers <4cm (T1a) and select 4-7cm (T1b) cancers – with equivalent cancer control and better preservation of kidney function than radical nephrectomy.

Partial nephrectomy for T1-2 kidney cancers is safe and effective compared to radical nephrectomy, however subtle differences do exist between the two treatments, in this randomized EORTC phase 3 study.

Metastatic or recurrent kidney cancer has many successful treatment options that prolong progression free survival and overall survival.

Localised kidney cancer has many treatment options available and each method needs to be explained to the patient to reach an informed decision.

Resection of the primary kidney cancer plus adjuvant cytokine therapy in patients presenting with metastatic disease is the standard of care.

Surgical removal of the primary kidney cancer in metastatic disease in association with cytokine treatment improves overall survival by 10 months.

Sunitinib is the first line cytokine therapy in good risk treatment naive metastatic kidney cancer providing a 6 month progression free survival benefit over IFN.

Temsirolimus is the standard of care for treatment naive poor risk metastatic kidney cancer with better overall survival than either IFN or combination therapy.

Lymphovascular invasion, sessile tumor, concomitant cis, high T stage and lymph node involvement portend a high risk of recurrence and death after radical nephroureterectomy for upper tract urothelial cancer.