How less can be more when treating some kidney cancers

Jan 09, 2008

A new Mayo Clinic study suggests that removing the entire kidney from younger patients with small kidney tumors may lead to decreased overall survival compared with an operation that removes the tumor but leaves the kidney intact. The study will be published in the February issue of the Journal of Urology.

Radical nephrectomy is a surgical procedure to remove the entire kidney along with the adrenal gland that sits atop the kidney and adjacent lymph nodes. In a partial nephrectomy, only the tumor is removed, sparing the surrounding normal kidney tissue.

“For patients with small kidney tumors, removal of the entire kidney may be associated with long-term consequences that we did not previously recognize when compared to removal of just the tumor,” says the study’s lead author, R. Houston Thompson, M.D., a Mayo Clinic urologist currently serving a fellowship at Memorial Sloan-Kettering Cancer Center. “Recent evidence suggests that there is a graded impact on survival based on declining overall kidney function. So as kidney function declines, the risk of heart attacks and heart-related events goes up, and consequently the risk of death from these events goes up.”

In this retrospective study, the research team reviewed the cases of 648 Mayo Clinic patients who underwent either a partial or radical nephrectomy for a kidney tumor 4 centimeters or smaller. In the 327 patients younger than 65 years of age, radical nephrectomy was significantly associated with death from any cause when compared with partial nephrectomy. Ten-year overall survival rates were 82 percent for patients treated with a radical nephrectomy and 93 percent for patients treated with a partial nephrectomy.

“We know the survival from cancer with partial nephrectomy or radical nephrectomy for patients with these small masses is excellent,” says Michael Blute, M.D., a Mayo Clinic urologist and senior author of the study. “Urologic surgeons need to consider long-term health consequences for patients with small renal mass undergoing complete nephrectomy.”

According to Dr. Thompson, less than 25 percent of patients who are treated surgically for small kidney tumors undergo a partial nephrectomy in the United States. “The fact that this is being performed in less than a quarter of cases raises a quality of care concern,” he says, adding that more study is needed.

Source: Mayo Clinic

Explore further: Early hormone therapy may be safe for women's hearts

add to favorites email to friend print save as pdf

Related Stories

Social Security spent $300M on 'IT boondoggle'

4 hours ago

(AP)—Six years ago the Social Security Administration embarked on an aggressive plan to replace outdated computer systems overwhelmed by a growing flood of disability claims.

Cheaper wireless plans cut into AT&T 2Q profit

4 hours ago

(AP)—AT&T posted lower net income for the latest quarter due to cheaper cellphone plans it introduced as a response to aggressive pricing from smaller competitor T-Mobile US.

Awarded a Pell Grant? Better double-check

4 hours ago

(AP)—Potentially tens of thousands of students awarded a Pell Grant or other need-based federal aid for the coming school year could find it taken away because of a mistake in filling out the form.

Recommended for you

Cancer: Tumors absorb sugar for mobility

10 hours ago

Cancer cells are gluttons. We have long known that they monopolize large amounts of sugar. More recently, it became clear that some tumor cells are also characterized by a series of features such as mobility or unlikeliness ...

Early hormone therapy may be safe for women's hearts

19 hours ago

(HealthDay)—Healthy women at low risk of cardiovascular disease may be able to take hormone replacement therapy soon after menopause for a short time without harming their hearts, according to a new study.

User comments : 0