**1. Introduction**

The incidence of kidney cancer is gradually increasing over the past 2–3 decades [1]. 60 920 new cases of RCC have been diagnosed in the US in 2011 and 13 120 died of cancer [2]. The widespread use of modern radiological studies has substantially changed clinical presenta‐ tion of the renal tumors. Currently, there is a trend towards more frequent diagnosis of asymptomatic, incidental, smaller lesions [1, 3]. Nephron sparing surgery (NSS) was initially used in the treatment of renal cell carcinoma (RCC) only for absolute and relative indica‐ tions [4]. Excellent oncological outcome and reduced morbidity after NSS have led to more frequent use of organ preserving surgery in many centers [4-7]. Elective NSS is currently the treatment of choice for T1a tumors (<4 cm) in the patients with a normal contralateral kid‐ ney. Its safety and oncological results have been evaluated in numerous studies [3, 8-10].

The role of NSS in the tumors of 4–7 cm in size is less evaluated and controversial. It could be technically challenging as well [10]. The existing studies suggest that this policy might be feasible and safe. In this paper we present our single centre experience in using the NSS for RCC of 4–7 cm in size.
