A new 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.
Radical nephrectomy is a surgical procedure to remove the entire kidney along with the adrenal gland that sits a top the kidney and adjacent lymph nodes. In a partial nephrectomy, only the tumor is removed, sparing the surrounding normal kidney tissue.
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 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.
Urologic surgeons need to consider long-term health consequences for patients with small renal mass undergoing complete nephrectomy.
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, more study is needed.
