Radical Nephrectomy Increases Kidney Disease

A new study suggests that with advances in imaging, almost 70% of kidney cancer patients have their tumor detected at a very small size, allowing surgeons to perform less radical surgery with superior results.

Researchers from Memorial Sloan-Kettering Cancer Center (MSKCC, New York, NY, USA) conducted a retrospective study of 662 kidney cancer patients. Results showed that up to 26% of the patients had pre-existing chronic kidney disease before undergoing surgery to remove a small tumor (less than 4 cm) from the kidney.

Patients with two otherwise healthy kidneys who underwent partial nephrectomy to remove a small cancer developed chronic kidney disease at a rate one-third lower than patients who underwent radical nephrectomy (removal of the entire kidney). The three-year probability of staying free of chronic kidney disease was 80% for the partial nephrectomy patients, compared with 35% for patients who underwent a radical nephrectomy. In fact, patients who had radical nephrectomy were more than twice as likely to develop chronic kidney disease.

"Our study clearly demonstrates, for the first time, the serious effects on kidney function and the high risk of chronic kidney disease when an entire kidney is removed for a small cancer. Chronic kidney disease leads to an increased risk of cardiovascular events, hospitalizations, and even death,” said Dr. Peter T. Scardino, chairman of the department of surgery and co-author of the study. "By removing only the cancerous part, we are much more likely to preserve a patient's normal kidney function and avoid the long-term consequences of chronic kidney disease.”

The latest U.S. nationwide analysis indicated that 92.5% of all kidney cancer surgeries from 1998 to 2002 were radical nephrectomies. Statistics in England for the same period reflected a similar trend; in 2002, 96% of kidney cancer surgeries performed in England were radical nephrectomies and 4% were partial nephrectomies.



Related Links:
Memorial Sloan-Kettering Cancer Center