Intraoperative Folate Targeted Fluorescence in Renal Cell Carcinoma

Inclusion criteria for localized RCC treated with partial nephrectomy

To be considered eligible to participate in this study, a patient must meet all the inclusion criteria listed below:

* ≥ 18 years of age.
* Have primary or suspected diagnosis of RCC, with presence of cT1-2 renal mass by diagnostic CT assessment.
* Scheduled for partial nephrectomy of renal mass.
* Expected survival of at least 3 months.
* Written informed consent available.
* ECOG ≤ 1 (Appendix G).
* Negative serum or urine pregnancy test within 24 hours for females of child bearing age
* Recovered from toxicity of any prior therapy to ≥ grade 1.

Inclusion criteria for advanced RCC treated with radical nephrectomy

To be considered eligible to participate in this study, a patient must meet all the inclusion criteria listed below:

* ≥ 18 years of age.
* Have pathologic or suspected diagnosis of RCC with presence of cT1-4 renal mass and evidence of nodal or metastatic involvement by diagnostic CT assessment
* Scheduled for radical nephrectomy and lymph node dissection.
* Expected survival of at least 3 months.
* ECOG ≤ 2.
* Negative serum or urine pregnancy test within 24 hours for females of child bearing age.
* Recovered from toxicity of any prior therapy to ≥ grade 1
* Written informed consent available.

Exclusion criteria for both localized and advanced RCC

* History of any anaphylactic reaction, any severe allergy, or any allergy to folate.
* Brain metastases
* Baseline GFR \< 50 mL/min/1.73m2)
* Hepatic toxicity ≥ Grade 2 (using CTCAE version 4 standard definitions).
* Participation in another investigational drug trial either concurrently or 30 days prior to surgery
* Any medical condition that in the opinion of the investigators could potentially jeopardize the safety of the patient, limit the patient's ability to complete the study, and/or compromise the objectives of the study.
* Known sensitivity to fluorescent light