Kidney cancer patients do better when whole kidney is not removed
Kidney cancer patients who had only their tumor removed had better survival than patients who had their entire kidney removed, according to a new study from researchers at the University of Michigan Comprehensive Cancer Center.
After an average of five years, 25 percent of patients who had a so-called partial nephrectomy, in which only the tumor and a small margin of healthy tissue is removed, had died, while 42 percent of patients who had radical nephrectomy, in which the entire kidney is removed, had died, the study found. Results appear in the April 18 Journal of the American Medical Association.
"For patients who are candidates for partial nephrectomy, it should be the preferred treatment option. We found that patients who were younger or had pre-existing medical conditions benefited most from partial nephrectomy," said lead study author Hung-Jui Tan, M.D., a urology resident at the U-M Medical School.
The researchers looked at 7,138 Medicare beneficiaries with early stage kidney cancer up to eight years after treatment. Patients were equally likely to die of kidney cancer, regardless of the type of surgery they received, suggesting that each procedure was equally likely to cure the cancer. The survival discrepancy was found in the number of patients who died from any cause.
The study showed that if only seven patients chose partial nephrectomy over radical nephrectomy, it would save one extra life.
Early stage kidney cancers have become more common recently. These are often discovered by chance when patients receive an X-ray or CT scan for something unrelated.
"As more and more people are identified with these small, early stage cancers, there's more interest in understanding how best to treat these patients," says senior study author David C. Miller, M.D., M.P.H., assistant professor of urology at the U-M Medical School and member of U-M's Institute for Health Care Policy and Innovation.
The question, though, is whether partial nephrectomy which is a more technically challenging procedure and potentially associated with more short-term complications is preferable to radical nephrectomy. Removing a kidney can increase the risk of chronic kidney disease, which is associated with lipid disorders, cardiovascular disease and renal failure.
The debate is similar to breast cancer surgery, in which studies have found that lumpectomy plus radiation is comparable to mastectomy. While that choice often comes down to a cosmetic trade-off, the trade-off with kidney cancer is a potential higher risk of short-term complications with partial nephrectomy vs. avoiding chronic kidney disease in the long term.
"This study does not suggest every patient with early stage kidney cancer should get a partial nephrectomy. It supports the notion that we need to expand the use of partial nephrectomy and make it a preferred treatment choice for patients with small tumors as much as possible, to optimize long term survival," Miller says.
More information: Journal of the American Medical Association, Vol. 307, No. 15, April 18, 2012
Journal reference:
Journal of the American Medical Association
Provided by
University of Michigan Health System
-
How less can be more when treating some kidney cancers
Jan 09, 2008 |
not rated yet |
0
-
Mayo Clinic finds surgeon caseload, practice setting affect treatment of small kidney tumors
May 15, 2011 |
not rated yet |
0
-
Kidney cancer surgery often determined by surgeons' practice style, not medical factors
Mar 10, 2008 |
not rated yet |
0
-
Kidney-preserving surgery saves bone health
Aug 05, 2011 |
not rated yet |
0
-
Researchers examine procedure utilization trends in patients with clinically localized renal masses
May 16, 2011 |
not rated yet |
0
-
Motion perception revisited: High Phi effect challenges established motion perception assumptions
Apr 23, 2013 |
3 / 5 (2) |
2
-
Anything you can do I can do better: Neuromolecular foundations of the superiority illusion (Update)
Apr 02, 2013 |
4.5 / 5 (11) |
5
-
The visual system as economist: Neural resource allocation in visual adaptation
Mar 30, 2013 |
5 / 5 (2) |
9
-
Separate lives: Neuronal and organismal lifespans decoupled
Mar 27, 2013 |
4.9 / 5 (8) |
0
-
Sizing things up: The evolutionary neurobiology of scale invariance
Feb 28, 2013 |
4.8 / 5 (10) |
14
-
Why is zone 1 in liver more prone to ischemic injury?
3 hours ago
-
How can there be villous adenoma in colon, if there are no villi there
23 hours ago
-
How can there be a term called "intestinal metaplasia" of stomach
May 21, 2013
-
Pressure-volume curve: Elastic Recoil Pressure don't make sense
May 18, 2013
-
If you became brain-dead, would you want them to pull the plug?
May 17, 2013
-
MRI bill question
May 15, 2013
- More from Physics Forums - Medical Sciences
More news stories
American cancer society celebrates 100 years of progress
(HealthDay)—The American Cancer Society, which is celebrating on Wednesday a century of fighting a disease once viewed as a death sentence, is making a pledge to put itself out of business.
Cancer
13 hours ago |
not rated yet |
0
CT detects twice as many lung cancers as X-ray at initial screening exam
National Lung Screening Trial (NLST) investigators also conclude that the 20 percent reduction in lung cancer mortality with low-dose computed tomography (LDCT) versus chest X-ray (CXR) screening previously reported in the ...
Cancer
14 hours ago |
not rated yet |
0
Research offers promising new approach to treatment of lung cancer
Researchers have developed a new drug delivery system that allows inhalation of chemotherapeutic drugs to help treat lung cancer, and in laboratory and animal tests it appears to reduce the systemic damage ...
Cancer
17 hours ago |
not rated yet |
0
|
Study details genes that control whether tumors adapt or die when faced with p53 activating drugs
When turned on, the gene p53 turns off cancer. However, when existing drugs boost p53, only a few tumors die – the rest resist the challenge. A study published in the journal Cell Reports shows how: tumors that live even i ...
Cancer
17 hours ago |
not rated yet |
0
|
Small increase in cancer risk following CT scans in childhood and adolescence
Study leader, Professor John Mathews from the University of Melbourne said this small increase in cancer risk must be weighed against the undoubted benefits from CT scans in diagnosing and monitoring disease.
Cancer
22 hours ago |
not rated yet |
0
US teen birth rate drops to record low
US teen births have dropped to a record low, but the country still has one of the highest rates among developed nations, the US Centers for Disease Control and Prevention said Thursday.
Slowing the aging process—only with antibiotics
Swiss scientists reveal the mechanism responsible for aging hidden deep within mitochondria—and dramatically slow it down in worms by administering antibiotics to the young.
Researchers complete largest genetic sequencing study of human disease
Researchers from Queen Mary, University of London have led the largest sequencing study of human disease to date, investigating the genetic basis of six autoimmune diseases.
Brain can be trained in compassion, study shows
Until now, little was scientifically known about the human potential to cultivate compassion—the emotional state of caring for people who are suffering in a way that motivates altruistic behavior.
Rate of bicycle-related fatalities significantly lower in states with helmet laws
Existing research shows that bicyclists who wear helmets have an 88 percent lower risk of brain injury, but researchers at Boston Children's Hospital found that simply having bicycle helmet laws in place showed a 20 percent ...
Having both migraines, depression may mean smaller brain
(HealthDay)—Migraines and depression can each cause a great deal of suffering, but new research indicates the combination of the two may be linked to something else entirely—a smaller brain.