Partial Surgery Spares Kidney Function

A new study finds that a large percentage of patients with small kidney tumors have their entire kidney removed as treatment, even though they may be suitable for surgery that removes only the cancer and spares the rest of the normal kidney, called partial nephrectomy.

Researchers at the University of Michigan Comprehensive Cancer Center (Ann Arbor, USA) looked at data concerning 14,647 people treated from 1988 to 2001 for kidney cancers less than 7 cm in size. During this 13-year interval, only 9.6% of patients were treated with partial nephrectomy, while the remaining 90% had their entire kidney removed. The results of the study appear in the March 2006 issue of the Journal of Urology.

The researchers found that for tumors smaller than 4 cm, removing only the tumor and a small margin of healthy tissue is just as effective at controlling the cancer as removing the entire kidney. However, not everyone with kidney cancer is eligible for partial nephrectomy. While tumor size is a major indicator of eligibility, other factors that should generally be considered include the location of the tumor within the kidney; overall kidney function; the presence of other medical conditions, including diabetes, high blood pressure, and kidney stones; and patient preference.

"For most surgeons, myself included, partial nephrectomy, whether open or laparoscopic, is likely to be a more difficult operation than removing the entire kidney. Many surgeons are able to take the whole kidney out laparoscopically but are less experienced performing partial nephrectomy laparoscopically,” said study author David Miller, M.D., clinical lecturer in urology at the University of Michigan Medical School, offering one explanation for the low prevalence of partial nephrectomy.






Related Links:
University of Michigan Comprehensive Cancer Center