Reprinted from the NCI Cancer Bulletin, vol. 5/no. 4, February 19, 2008 (see the current issue).
The use of partial nephrectomy to treat small, newly diagnosed kidney tumors appears to be vastly underused, researchers from the New York University School of Medicine are reporting.Studies have shown that partial nephrectomy, only removing the part of the kidney in which a small tumor (typically 4 centimeters or less) resides, produces equivalent outcomes to complete removal of the kidney, or radical nephrectomy, and may prevent the development of a serious side effect, chronic kidney disease. Nevertheless, the researchers reported last week at the American Society of Clinical Oncology Genitourinary Cancers Symposium, it is offered to only one of every five patients with newly diagnosed, small tumors.
To conduct the study, Dr. William Huang, an assistant professor of urologic oncology, and colleagues analyzed data from NCI's Surveillance, Epidemiology, and End Results program on more than 3,000 patients treated for these small renal tumors from 1995 through 2002. The incidence of kidney tumors has been steadily climbing for several decades, largely due to the incidental discovery of these small tumors during imaging procedures for other problems, Dr. Huang explained during a press briefing.
The research team identified preoperative factors that differed between the more than 2,500 patients with small renal tumors who underwent radical nephrectomy and the 556 who underwent partial nephrectomy. Patients treated with partial nephrectomy were more likely to be younger, male, and treated toward the end of the period covered by the study, which, Dr. Huang noted, could suggest the beginning of a shift toward more partial nephrectomies in patients with small tumors. Women, older patients, and patients with cerebrovascular disease were less likely to have partial nephrectomy.
"Partial nephrectomy is an option for most patients with newly diagnosed kidney tumors," Dr. Huang concluded, "and actually may be a better option because [patients] with kidney tumors often have other comorbid conditions."