Partial Nephrectomy Rates Rise, but Disparities Exist

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PARIS—Partial nephrectomy (PN) rates have increased dramatically, but this surgical approach is underused in certain patient populations, according to data presented at the 27th Annual Congress of the European Association of Urology.

The data came from a study of 375,986 patients in the United States who underwent either PN or radical nephrectomy from 1998 to 2009. During this period, the PN rate rose from 6% to 28%, according to investigator Maxine Sun, PhD, who reported the study findings. In addition, the study showed that increasing age and multiple comorbidities were associated with a lower rate of PN.

“We also found that patients with private insurance were more likely to get partial nephrectomy relative to Medicare and Medicaid patients,” Dr. Sun said.

Compared with privately insured patients, Medicare, Medicaid, and uninsured patients were 10%, 17%, and 21% less likely to undergo PN, the study found.

Furthermore, patients with higher income and those treated at high-volume and teaching hospitals were more likely to receive PN. Patients treated at teaching hospitals were 46% more likely to undergo PN than those treated at non-teaching hospitals. Compared with patients in the lowest quartile of income (based on zip code), those in the highest quartile were 15% more likely to undergo PN.

PN rates did not differ significantly by race or gender or by urban or rural hospital location.

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