Success in the surgical management of malignant tumors in any part of the body depends on early recognition and complete removal; furthermore, this is the only absolute cure for malignant conditions that is known at the present time. The application of this principle to malignant disease of the urinary tract has been especially difficult, owing to the commonly insidious onset of the disease and the impossibility of its discovery while sufficiently localized to permit of its entire elimination.
This is particularly true regarding malignant disease of the kidney. Here the earliest signs and symptoms may be long delayed in their onset, the cardinal symptoms (pain, tumor and hematuria) not being noticeable or recognized as serious until the growth is no longer confined to the kidney. The emphasis placed by urologists on the significance of painless hematuria is, however, beginning to bear fruit, and unquestionably a larger number of renal tumors
BUGBEE HG. SURGERY OF GENITO-URINARY MALIGNANT TUMORS. JAMA. 1939;112(4):298–301. doi:https://doi.org/10.1001/jama.1939.02800040016005
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