Radical Surgery is Risk Factor

Being less radical keeps kidneys
healthier; © NCI Visuals Online

The study revealed that patients with two otherwise healthy kidneys who underwent kidney-sparing surgery (partial nephrectomy) to remove a small cancer developed chronic kidney disease at a rate one-third lower than patients whose entire kidney was removed (radical nephrectomy). The three-year probability of staying free of chronic kidney disease was 80 percent for the partial nephrectomy patients compared with 35 percent for patients who underwent a radical nephrectomy. In fact, radical nephrectomy was shown to be a significant risk factor for developing chronic kidney disease.

"The results of our study demonstrate that prior to surgery, the baseline kidney function of patients with small kidney tumours was significantly lower than previously recognized," explained Dr. William C. Huang, the study's first author. "Patients who undergo a radical nephrectomy, the most common treatment for small kidney tumours, are at significantly greater risk for the development of chronic kidney disease after surgery compared with those who undergo a partial nephrectomy."

The retrospective study of 662 patients at Memorial Sloan-Kettering Cancer Center (MSKCC) showed that up to 26 percent of the patients had pre-existing chronic kidney disease before undergoing surgery to remove a small tumour (less than 4 cm) from the kidney. In addition, those patients who had the entire kidney removed were more than twice as likely to develop chronic kidney disease.

Researchers add that with advances in imaging, almost 70 percent of kidney cancer patients have their tumour detected at a very small size (less than 4 cm), allowing surgeons to perform less radical surgery with superior results. "Evidence has accumulated from our Center and elsewhere that partial nephrectomy provides effective local tumour control and equivalent survival rates to that of radical nephrectomy for small tumours," said Dr. Paul Russo, the study's senior author.

MEDICA.de; Source: Memorial Sloan-Kettering Cancer Center