Kidney cancer
Diagnosis & treatment in Vienna

What is kidney cancer?

Renal cell carcinoma is the most common malignant kidney tumour in adults. Risk factors include smoking, obesity, high blood pressure and rare hereditary syndromes. Most patients are between 60 and 70 years old.

More than half of kidney tumours are now found by chance – on an ultrasound or CT done for another reason. Symptoms such as blood in the urine, flank pain or a palpable mass appear late. Thanks to early detection, most tumours are small and highly curable at diagnosis.

Not every kidney mass is malignant: cysts and benign tumours such as angiomyolipoma or oncocytoma can look similar on imaging. Careful assessment prevents unnecessary surgery.

Assessment of a kidney tumour

The basis is a contrast-enhanced CT or MRI. It shows the size and position of the tumour and its relationship to vessels and the renal pelvis, and in most cases allows a reliable assessment. A biopsy is only needed in selected situations, for instance before active surveillance or ablation.

Ultrasound of the kidneys Contrast-enhanced CT or MRI Kidney function (creatinine, GFR) and urinalysis If needed: renal biopsy For larger tumours: staging with chest CT

Treatment of kidney cancer

01.
Active surveillance

Small tumours under 3–4 cm usually grow slowly and rarely spread. For older patients or those with significant other conditions, monitoring with regular imaging can be the safest choice.

02.
Robot-assisted partial nephrectomy

For localised tumours, kidney-sparing removal is the standard: the tumour is removed with a narrow margin of healthy tissue and the kidney is preserved. With the da Vinci system this is achieved precisely even in complex locations, with only a short interruption of blood flow.

More about partial nephrectomy
03.
Radical nephrectomy

For large or centrally located tumours where the kidney cannot sensibly be preserved, the whole organ is removed minimally invasively. The remaining kidney usually takes over the function completely.

04.
Ablation and systemic therapy

For selected small tumours, cryo- or radiofrequency ablation is available. In metastatic disease, treatment with immunotherapy and targeted drugs is planned in the multidisciplinary tumour board.

Frequently asked questions

Does the whole kidney have to be removed?

Rarely. For most tumours under 7 cm a partial nephrectomy is possible, protecting kidney function – important for blood pressure, the heart and the prevention of dialysis.

How soon must a kidney tumour be operated on?

Small tumours are not an emergency; a few weeks until surgery are safe. Large or rapidly growing tumours should be treated promptly.

What happens after surgery?

After robotic partial nephrectomy you are usually home within two to four days. Follow-up includes regular CT or ultrasound checks and kidney function tests over several years.

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